History of metastatic testicular cancer with brain metastases, treatment planning for SRS. There is redemonstration of two enhancing masses within the left frontal lobe. The larger mass measures approximately 19 x 28 x 23 mm and straddles the central sulcus with significant adjacent vasogenic edema and appears not significantly changed. There is some adjacent dural thickening which is likely reactive. There is an additional smaller and slightly inferiorly located subcentimeter enhancing lesion within the left centrum semiovale with surrounding mild adjacent vasogenic edema. There is susceptibility abnormality within the two lesions indicating intratumoral hemorrhage/hemosiderin. No additional intracranial lesions are identified.The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Mild relatively uniform enhancement of the clivus and central skull base is seen, nonspecific. No other definite osseous lesions are detected.
Limited treatment planning images again demonstrate two enhancing hemorrhagic masses within the left frontal lobe compatible with metastases, with the larger lesion straddling the central sulcus and causing significant local edema, not significantly changed compared to 8/13/2016.