Metastatic lung cancer with leptomeningeal disease treated with Alectinib x 2 cycles. There has been interval decrease in the degree of leptomeningeal carcinomatosis and associated vasogenic edema. There is also interval appearance of sulcal susceptibility effect in the right central sulcus, where there is persistent enhancement. There is an unchanged focus of susceptibility effect in the right superior frontal gyrus where there is also residual enhancement. There is no evidence of intracranial hemorrhage, mass, or acute 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 orbits, skull, and scalp soft tissues are grossly unremarkable. There are secretions and mucosal thickening in the right sphenoid sinus.
Interval decrease in the degree of leptomeningeal carcinomatosis and associated vasogenic edema.