Clinical question: Evaluate for progression of metastatic breast cancer status post RT. Signs and symptoms: Breast cancer with brain metastases status post RT. Negative cytology. Pre and post enhanced brain MRI:Extensive for the hyperintensity in the left cerebellum and its associated mass effect on the fourth ventricle demonstrate no definitive interval change. Within this region a cystic hemorrhagic focus with extensive enhancement demonstrate no convincing evidence of interval change in overall appearance. Findings represent site of a previous surgical intervention. It remains unclear whether there is residual tumor at this site or the extent of findings are demonstrated postoperative findings. Further follow-up is recommended.There is revisualization of a well-demarcated uniformly enhancing mass in the right temporal lobe measuring 10 x 9 mm in transaxial dimensions which is larger than prior study measurement of 6.7 x 6.7 mm. There is no surrounding vasogenic edema or appreciable mass effect with this finding.There is no evidence of any new abnormal foci of parenchymal or leptomeningeal enhancement. Calvarium demonstrate normal signal intensity and without abnormal enhancement.Unremarkable images through the orbits and including axial fat sat post enhanced series.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal pattern.
1.Stable extensive FLAIR hyperintensity, internal foci of hemorrhage, extensive enhancement and subtle mass effect in the left cerebellum since prior exam. It remains unclear whether there is residual tumor within this region or findings represent post surgical changes. Follow-up is needed. 2.Interval increased size of a superficially located right temporal enhancing mass measuring at 10 x 8.5 mm compared to prior study measurement of 6.7 x 6.7 mm.3.No detectable new foci of parenchymal, leptomeningeal, calvarial or orbital enhancement.