Metastatic head and neck cancer with suspicious mass and neck CT. There is redemonstration of a 5 mm enhancing nodule involving the left frontal pericallosal white matter, which is unchanged in size compared to prior CT head from 4/26/2015. No other enhancing mass or evidence of intracranial mass effect. There is no evidence of large acute intracranial hemorrhage or acute infarct. There are minimal scattered punctate foci of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, which are nonspecific. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. Incidental note is made of a right frontal lobe developmental venous anomaly. There is a 7 mm focus of enhancement within the right parietal bone, a 11 mm enhancing lesion within the right aspect of the clivus as well as 11 mm enhancing lesion in the left occipital condyle. The left parotid gland is atrophic, unchanged.
1.A 5 mm enhancing nodule involving the left frontal lobe pericallosal white matter is unchanged in size compared to CT head from 4/26/2015 and is suspicious for intracranial metastasis. Mild associated edema without significant mass effect. No other enhancing parenchymal lesion is identified.Enhancing lesions within the right parietal bone, right clivus and left occipital condyle as described above, suspicious for osseous metastases. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.