NSCLC brain metastases status post WBRT and SRS to caudate lesion. Now on TMZ+crizotinib. There are innumerable supratentorial and infratentorial metastases, the majority of which demonstrate associated susceptibility effect and ring-enhancement. There has been interval decrease in size of the lesion centered in the right caudate head, which now measures up to 16 mm, previously 19 mm. While most of the other lesions have not significantly changed, there has been slight increase in size and associated edema of a few lesions. There is also progressive leptomeningeal extension associated with some of the lesions and along the partially-imaged cervical spine. There is no evidence of intracranial hemorrhage or acute infarct. There is no midline shift or herniation. The ventricles are unchanged in size and configuration. The skull appears unchanged. However, there has been interval increase in size of a left masseter muscle lesion, now measuring up to 12 mm, previously 8 mm.
1. Innumerable supratentorial and infratentorial metastases. The lesion centered in the right caudate head has decreased in size. While most of the other lesions have not significantly changed, there has been slight increase in size and associated edema of a few lesions.2. Progressive leptomeningeal extension associated with some of the lesions and along the partially-imaged cervical spine suggestive of leptomeningeal carcinomatosis. 3. Interval increase in size of a probable metastasis in the left masseter muscle.