Diagnosis: Malignant neoplasm of thyroid gland Secondary malignant neoplasm of brain Secondary malignant neoplasm of unspecified lungClinical question: h/o met thyroid ca, compare to previous, measurements plsSigns and Symptoms: none The patient is status post right-sided craniotomy involving frontal and parietal bones and part of the squamous temporal bone. There is abnormal signal within the posterior aspect of the right inferior frontal gyrus and the subcentral lobule associated with volume loss and some susceptibility effect. Stable when compared to the prior exam. The appearance on postcontrast imaging is stable. There is T1 hyperintensity within this lesion. There are some contrast enhancement along the areas of susceptibility effect stable since the prior exam.A punctate enhancing focus along the left superior cerebellar hemisphere remains stable compared to the prior examNormal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate a mucous retention cyst in the right maxillary sinus and some mild mucosal thickening in the ethmoid air cells as well as some minor opacities in the right maxillary sinus.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.The patient is status post right-sided craniotomy for a lesion centered in the right frontal lobe. There are posttreatment effects present in the surgical bed which appear stable. Some contrast enhancement at the surgical bed is present which is stable and could be due to posttreatment effect.2.A punctate lesion in the left superior cerebellar hemisphere remains stable.