 There is a 3.1 cm transverse x 3.5 cm AP x 3.1 cm craniocaudal ring-enhancing lesion involving the left temporal lobe. There is associated vasogenic edema as well as small hemorrhagic components within the posterior aspect of a necrotic appearing center.A second, small, ring-enhancing lesion measuring 5 x 8 mm is present within the posterior left occipital lobe.There are scattered punctate foci of T2 hyperintensity in periventricular, although primarily subcortical, white matter locations without mass effect or restricted diffusion.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Minimal mucosal thickening within the left frontal and a couple left ethmoid sinuses. The remaining paranasal sinuses and mastoid air cells are clear.
1.There are 2 ring-enhancing lesions, one large within the left temporal lobe, one tiny within the left occipital lobe. Given a history of lung cancer, this is most consistent with metastasis.2.Mild chronic small vessel ischemic disease.