Female, 63 years old, history of metastatic lung cancer status post 5 cycles of carbo/paclitaxel. An enhancing lesion is present within the left occipital lobe measuring 8 x 5 mm (image 28 series 13) which, accounting for differences in technique, is approximately unchanged relative to the prior head CT. Mild local T2 hyperintense edema is seen.An enhancing lesion is present within the right inferior lateral cerebellum measuring 8 x 7 mm (image 13 series 13). This lesion cannot be identified on prior exams due to limitations of the CT technique. This lesion demonstrates minimal T2 hyperintensity and no significant edema or mass effect.Two enhancing lesions are demonstrated within the subcutaneous tissues of the occipital scalp. The midline lesion has clearly increased in size from prior examinations, measuring 12 x 7 mm on today's study, while on the first head CT it was no more than 4 mm in maximal diameter. The lesion to the right of midline is probably mildly increased from prior exams as well.A few small foci of T2 hyperintensity are evident within the periventricular and subcortical white matter and these are nonspecific. No additional areas of pathologic intracranial enhancement are seen. No evidence of significant mass effect is demonstrated. No acute intracranial hemorrhage or any abnormal extra-axial fluid is detected. Ventricles are normal in size and morphology.The marrow signal characteristics are within normal limits. Mucosal thickening is seen at the floor of the left maxillary sinus.
1. A metastatic lesion within the left occipital lobe has probably not significantly changed in size relative to prior exams and accounting for differences in technique.2. A second lesion suspected to represent a metastasis is seen in the right inferior cerebellum. This lesion could not be identified on prior CT exams due to limitations of the technique and therefore interval change cannot be assessed.3. Two enhancing subcutaneous nodules in the occipital scalp, also very suspicious for metastases, are seen. Both of these lesions have likely increased in size from prior exams, most notably the midline lesion. 