History of metastatic adenoid cystic carcinoma status post radiation. Evaluate response. Redemonstration of enhancing lesions in both the supratentorial and infratentorial brain predominantly in a subcortical distribution. There is extensive adjacent vasogenic edema surrounding the lesions, and most demonstrate internal susceptibility compatible with internal microhemorrhage.Compared to prior there are no definite new lesions. Almost all of the previously noted lesions are, however, increased in both size and surrounding edema when compared to prior compatible with progression. The referenced left caudate lesion measures 16 x 13 mm (series 11 image 77), previously 14 x 7 mm. The reference right parietal lesion is difficult to measure on axial images as it moves obliquely out of the axial plane, but measures 25 x 14 mm (series 11 image 52), previously 22 x 13 mm. The reference right cerebellar lesion now measures 37 x 24 mm (series 11 image 5), previously 22 x 13 mm.Again seen is a focus of nonspecific enhancement within the left parietal bone, without significant change from the prior exam.The ventricles and basal cisterns are normal in size and configuration. No pathologic extra-axial fluid collection. Normal flow void is demonstrated in the major intracranial vascular structures.
Interval increase in size and number of metastatic lesions within the brain compatible with disease progression. There has also been interval increase in perilesional vasogenic edema. 