Esophageal cancer. There is interval decrease in size of the mass in the left temporo-occipital region, now measuring up to 23 mm, previously 25 mm. Likewise, there is interval decrease in size and enhancement of the mass in the left frontal lobe, now measuring up to 14 mm, previously 17 mm. In addition, the non-enhancing right frontal lobe lesion measures up to 4 mm, previously 5 mm. There is no evidence of intracranial hemorrhage or acute territorial infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, orbits, and scalp soft tissues are unremarkable. However, there is persistent fluid within the bilateral middle ears and mastoid air cells and mild scattered paranasal sinus mucosal thickening.
1. Overall continued interval decrease in size of the brain metastases.2. Persistent fluid within the bilateral middle ears and mastoid air cells, which may represent otomastoiditis.