Malignant neoplasm of unspecified part of unspecified bronchus or lung [C34.90] / Disseminated malignant neoplasm, unspecified [C80.0] / Encounter for antineoplastic chemotherapy [Z51.11] / Encounter for examination for normal comparison and control. There are multiple variable sized the abnormal enhancing nodules including left precentral sulcus suspicious posterior aspect of pars opercularis, left frontal lobe inferior frontal gyrus pars orbitalis, right mesial thalamus, right anterior aspect of superior temporal gyrus and posterior aspect of middle temporal gyrus, medial aspect of left middle cerebellar peduncle and inferior aspect of the left cerebellar hemisphere. Considering the patient clinical history, these enhancing nodules represent multiple metastatic lesions.There is also localized not clearly circumscribed area of replacement of normal fatty marrow of skull on the midline occipital bone which shows inhomogeneous enhancement. This finding could also represent focal bony metastasis. Thus, if indicated, either head CT scan with thin section around occipital bone or bone scan can be considered for further imaging evaluation if clinically indicated.There is no evidence of acute ischemic or hemorrhagic lesion on the scan.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Multifocal bihemispheric, supra and infratentorial variable sized enhancing nodules as described above, compatible with multifocal intracranial metastasis.2. Possible occipital bone lesion as described above.