New diagnosis of lung cancer. Evaluate for brain metastasis. There is a well-circumscribed 11 mm pineal region mass which shows solid contrast enhancement. There is minimal cerebral white matter T2 hyperintensity. The brain parenchyma and pituitary gland appear unremarkable. Otherwise, there is no evidence of brain parenchymal enhancing lesions, intracranial hemorrhage, or acute infarct. The ventricles and basal cisterns are normal 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 is minimal maxillary sinus mucosal thickening. There is also minimal fluid within the left mastoid air cells.
1.A pineal mass with solid enhancement that measures up to 11 mm may represent a perineal parenchymal tumor versus an isolated lung cancer metastatic lesion. Follow-up imaging is recommended to confirm stability.2.Minimal cerebral white-matter T2 hyperintensity is nonspecific, but may reflect chronic microvascular ischemia.3.No evidence of intracranial hemorrhage or acute infarct. 