Head and neck cancer as well as lung cancer and a new mass within the left cerebellar hemisphere on CT neck: evaluate for metastatic disease. There appear to be four supratentorial and infratentorial peripherally-enhancing masses with surrounding T2 hyperintensity. For example, a left cerebellar hemisphere lesion measures up to approximately 25 mm and a left parietal lobe lesion measures up to approximately 22 mm. There are otherwise a few unchanged scattered nonspecific foci of punctate T2 hyperintensity in the cerebral white matter without associated enhancement. There is no evidence of intracranial hemorrhage or acute infarct. There is mild effacement of the fourth ventricle, but no dilatation of the third and lateral ventricles. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
A few supratentorial and infratentorial masses with associated edema are compatible with metastatic disease.