Reason: still needs contrast exam History: brain lesion There is a 22 x 3 mm axial dimension mass along the medial aspect of the right frontal lobe involving cingulate gyrus. It appears to have two components one which is attached to the falx cerebri which measures a 24 x 16 mm axial dimensions and the surrounding component which appears to be involving the brain parenchyma. The parafalcine component has lower T2 signal and appears to have some flow voids and as a heterogeneous 4 as the component that invades the brain and the leptomeninges appears to enhance more and is associated with bright T2 signal and also is associated with flow-voids. There is associated vasogenic pattern edema.
1.There is a right parafalcine mass present which involves the adjacent right cingulate gyrus and right frontal lobe. This appears to be composed of to differing components one component is extra-axial another one at the invades the leptomeninges and extends into the brain. Differential considerations include metastatic disease as well as lymphoma, granulomatous disease and in an unusual set of circumstances a superimposed metastasis to a meningioma.