Metastatic apocrine adenocarcinoma status post brain tumor resection. There are recent postoperative findings related to right temporal craniotomy for resection of a right anterior temporal lobe tumor. There is an area of restricted diffusion along the posterior aspect of the resection cavity that measures up to 25 mm and a small amount of blood products within the cavity, but no evidence of gross residual enhancing tumor. There is extensive confluent T2 hyperintensity surrounding the resection cavity. There is associated 6 mm of midline shift to the left and partial effacement of the third and right lateral ventricles. There is mild prominence of the left lateral ventricle. There is swelling of the scalp tissues overlying the craniotomy site. There is a partially-imaged large left paraspinal tumor adjacent to the craniocervical junction with compression of the left internal jugular vein and slow flow in the ipsilateral dural venous sinuses. There also appears to be an enlarged left preauricular lymph node.
1. No evidence of gross residual enhancing tumor in the anterior right temporal lobe status post recent resection, although surrounding vasogenic edema with mild midline shift persists.2. Partially-imaged large left paraspinal metastasis adjacent to the craniocervical junction.3. Apparent enlarged left preauricular lymph node, which may also represent metastatic disease.