Female, 72 years old, with metastatic breast cancer to the brain, treatment planning MRI for radiation therapy. A hemosiderin stained resection cavity is present in the right paramedian parietal lobe compatible with prior resection of a metastatic lesion from this location. The surgical cavity is approximately the same size as that seen on the immediate postoperative exam. Since the immediate postoperative examination, patchy peripheral enhancement has developed along the margins of the cavity which, in some areas, appears rather gyriform in nature. Redemonstrated is a heterogeneously but briskly enhancing lesion within the inferior left cerebellum. This lesion measures approximately 22 x 17 mm which is unchanged from the preoperative evaluation. The lesion is associated with fairly strong susceptibility artifact which may reflect internal blood product.No new enhancing lesions are identified. No new or significant generalized mass effect is seen. The ventricular system is within normal limits.
1.Interval development of patchy somewhat gyriform enhancement around the margins of the right parietal resection cavity. This is nonspecific but favored to represent postoperative granulation rather than residual/recurrent tumor.2.No significant interval change in the size or appearance of a second metastatic lesion in the left cerebellum.3.No evidence of any new intracranial lesion is seen.