Male, 54 years old, with blurry vision and a subtle left posterior globe lesions seen on prior CT imaging. History of base of tongue cancer. An enhancing intraocular mass is evident on the left along the posterior inferior aspect of the globe. This lesion measures 14 x 7 mm in the axial plane and has increased in size from the prior CT where it was very subtle.The choroidal layer of the left globe is uniformly enhancing and there appears to be some mild separation of the choroid from the underlying sclera, at least laterally if not medially. The periorbital tissues on the left are diffusely inflamed with evidence of abnormal signal and strandy enhancement both intraconally and extraconally.A 6 mm enhancing lesion is partially visualized within the left anterior cerebellum.
1.An intraocular mass on the left has increased in size from the prior examination. Given the clinical history of head and neck cancer, the findings are concerning for a metastatic lesion.2.In addition, there is diffuse left choroidal inflammation with a mild degree of choroidal detachment suspected at least on the left, with or without subchoroidal bleeding. Generalized left orbital inflammation is seen both intraconally and extraconally.3.A 6 mm enhancing lesion within the left anterior cerebellum is partially visualized on this examination. Dedicated contrast enhanced brain MRI is recommended to assess for the possibility of intracranial metastases.