Male, 58 years old, with known brain metastases. Preparing for radiotherapy. Numerous, at least 15, solidly enhancing parenchymal metastases are demonstrated. Lesions are seen within both cerebral hemispheres and within the left cerebellum. The largest lesion, in the left frontal lobe, measures 34 x 28 mm and induces significant regional edema. There is associated sulcal effacement, deformation of the left lateral ventricle and a slight midline shift to the right. The other intracranial lesions range in size from punctate up to about 2 cm and cause variable but milder degrees edema.Encephalomalacia of the right inferior frontal lobe is seen. The overlying calvarium demonstrates changes suggestive of prior surgery. No findings to suggest acute intracranial hemorrhage or any abnormal extra-axial fluid collections are seen. Apart from contour deformity related to regional edema, the ventricular system is unremarkable with no evidence of hydrocephalus.
Numerous parenchymal metastases are identified ranging in size from punctate up to several centimeters. The largest lesion is found in the left frontal lobe.