Reason: breast cancer with brain met; RT planning for SRS History: RT planning; no neuro symptoms The previously seen superior left cerebellar punctate enhancing nodule has decreased in size, now measuring 3 x 3 mm on 401/75, as compared to previous 5 x 6 mm. There is associated punctate susceptibility now, with mild T2 hyperintensity.There are a few areas of ill-defined enhancement within the calvarium bilaterally, slightly more conspicuous. The areas along the vertex are more rounded in configuration (401/155 and 160). One rounded lesion along the left parietal bone (403/71) is not definitely seen on the prior exam. Review of outside bone scan seems to suggest some areas of corresponding focal uptake in the calvarium.The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There are no new areas of abnormal signal or pathological parenchymal enhancement. No extra-axial fluid collection is identified.
1. Interval decreased size of single left superior cerebellar enhancing nodule, now only measuring 3 mm.2. Multiple areas of ill-defined calvarial enhancement, appearing more rounded near the vertex, suspicious for osseous metastatic disease especially given recent bone scan correlation. These appear minimally progressed since prior.