Lung cancer in two brain metastases treated with CyberKnife. Surveillance imaging. There is interval decrease in size of the ring-enhancing lesion in the left superior frontal gyrus, now measuring up to 14 mm, previously 18 mm, although the vasogenic edema persists. However, there is interval increase in size of an enhancing lesion in the inferior right parietal lobe, which now measures up to 5 mm, previously 2 mm, and there is development of associated vasogenic edema. There is also interval increase in size of the right inferior temporal gyrus enhancing lesion, now measuring up to 8 mm, previously 5 mm, as well as increased associated vasogenic edema. In addition, there are two new punctate enhancing lesions in the left middle frontal gyrus with trace vasogenic edema. 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 orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Interval decrease in size of the left superior frontal gyrus metastasis, but interval increase in size of the inferior right parietal lobe and right inferior temporal gyrus metastases and associated vasogenic edema and new punctate metastases is in the left middle frontal gyrus.