Clinical question: Breast cancer with brain metastases, compare to last MRI. Signs and symptoms: Post 2 cycles of chemotherapy. Pre and post enhanced brain MRI is performed.No diffusion-weighted abnormalities.Examination redemonstrates multiple supratentorial metastatic lesions with evidence of interval progression of disease.Example left frontal necrotic rim-enhancing metastatic tumor measures at 20 x 20 mm compared to prior study measurement of approximately 10 mm. A right inferior temporal metastatic tumor measuring at 12 mm compared to prior study measurement of 4 mm. A left parietal periventricular metastatic lesion measuring 13 x 16 mm compared to prior study measurement of 8 x 10 mm. A right frontal superficial necrotic enhancing tumor measures at 19 x 17 mm compared to prior study measurement of 10 x 8 mm.There is also evidence of interval increased surrounding vasogenic edema of the metastatic lesions however without mass effect on the ventricular system or deviation of midline.There is no detectable leptomeningeal enhancement.Ventricular system remain within normal size and with maintained midline.Calvarium demonstrate normal signal intensity and without evidence of metastases.
1.Interval progression of metastatic disease with increased size of all supratentorial metastatic lesions as detailed/measured above.2.Interval subtle increased surrounding vasogenic edema however with regional mass effect and no midline shift.