Metastatic base of tongue squamous cell carcinoma, treated with pembrolizumab, palliative RT to left orbit, and started palliative carbo/paclitaxel/cetuximab. The left cerebellar tonsil lesion is now less conspicuous. However, there are now several new and/or more conspicuous, but subcentimeter lesions elsewhere in the bilateral cerebellar hemispheres and right anterior frontal lobe, without discernible vasogenic edema. The left posterior globe lesion is no longer discernible. There is no evidence of acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull and scalp soft tissues are grossly unremarkable. There is a left maxillary sinus retention cyst.
1. Interval evolution of the subcentimeter left cerebellar tonsil metastasis, likely due to treatment effects. However, there are now several new and/or more conspicuous, but subcentimeter lesions in the bilateral cerebellar hemispheres and right anterior frontal lobe, which may represent additional metastases.2. The left ocular metastasis is no longer discernible.