Metastatic small cell lung cancer treated with WBRT on 9/27/16. There are postoperative findings related to right frontal craniotomy, with underlying confluent high T2 signal with encephalomalacia and susceptibility effect in the right frontal lobe, and an unchanged subcentimeter area of enhancement. Otherwise, there are multiple supratentorial and infratentorial lesions, some of which have not significantly changed or are smaller, while some are larger. For example, a left middle frontal gyrus lesion measures up to 9 mm in diameter, previously 5 mm, and displays increased vasogenic edema, a right perirolandic lesion measures 17 mm, previously 12mm, and displays increased vasogenic edema, a left cerebellar lesion measures up to 7 mm, previously 10 mm, and displays less enhancement, a left thalamus lesion measures up to 5 mm, previously 9 mm, and a posterior medulla lesion measures approximately 5 mm in diameter, previously also 5 mm. In addition, there is a new punctate left posterior cingulate gyrus lesion. Many of the lesions contain hemorrhagic components with high T1 signal. There is no evidence of 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.
1. Findings suggestive of mixed response of the multiple intracranial metastases.2. Postoperative findings related to right frontal craniotomy, with an unchanged nonspecific subcentimeter area of enhancement. 