Clinical question: Preop for OR today. Signs and symptoms: Brain tumor Pre- and post enhanced brain MRI:Examination is performed utilizing a Stealth protocol and is not a true diagnostic study.Small ring-enhancing metastatic lesion in the right cerebellum measuring at 9 x 8 mm without significant change since prior exam. Large necrotic ring-enhancing tumor in the left occipital with extensive surrounding vasogenic edema is again identified. It measures at least at 44 x 25 x 43 Without significant change since prior study. Tumor similar to prior exam appears to encase the tip of the left occipital horn of lateral ventricle. There is no detectable additional foci of parenchymal, meningeal or calvarial enhancement.Mildly prominent supratentorial ventricular system without interval change since prior exam or deviation of midline.
1.Large necrotic metastatic enhancing tumor measuring up 44 x 25 x 43 in the left occipital and posterior temporal and a small 9 x 8 mm right cerebellar metastatic lesions without significant change.2.No additional parenchymal, leptomeningeal or calvarial abnormal enhancement.