Calvarium metastases from breast cancer. There has been gradual decrease in size of multiple heterogenously enhancing skull lesions. The largest of these is located in the occipital bone with epidural extension and mass effect upon the torcula herophili. This lesion now measures approximately 20 x 65 mm in cross-section, versus 32 x 72 mm in January 2015. There is no evidence of abnormal brain parenchymal or leptomeningeal enhancement. There is no evidence of intracranial hemorrhage or acute infarct. The pituitary gland appears unremarkable. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There is unchanged deformity of the right lamina papyracea defect with protrusion of orbital fat. There is nonspecific fluid within the mastoid air cells, right more than left.
1. Gradual decrease in size of multiple skull metastases.2. No evidence of leptomeningeal or intraparenchymal brain metastases.