68 years Male (DOB:9/11/1947)Reason: Hx of lung CA, please compare to previous and measure History: New lesions per PET on 7/20PROVIDER/ATTENDING NAME: BRITTANY L BEACH BAKHTIAR L YAMINI The patient status post left-sided frontal craniotomy and left-sided temporal craniotomy. There is adjacent dural thickening and enhancement at the craniotomy sites.There is encephalomalacia present along the left frontal lobe anteriorly which was also present on the prior exam and associated with some loss of volume and ex vacuo effect on the left lateral ventricle. There is a smaller focus of encephalomalacia in the left temporal lobe along the inferior temporal gyrus. There is thickening of the dura and surface of the encephalomalacic brain at the left frontal lobe which was also present on the prior exam but has regressed.There is a 3 mm punctate focus of enhancement redemonstrated in the left temporal lobe at the surgical site. This was not present on exams from 2014, 2013 and 2012 but was present on the 2011 exam.Normal 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 are clear. The right maxillary sinus is smaller than the left maxillary sinus The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Status post left frontal and temporal lobes surgeries for tumor removal. 2.A punctate focus of enhancement in the left temporal lobe is stable compared to the prior exams. The possibility this represents neoplasia cannot be excluded. It is too small to characterize further.3.There is interval regression of a focus of enhancement involving the dura and surface of the left frontal lobe at the prior frontal craniotomy site. It is suspected is mostly represents scar.