Secondary malignant neoplasm of brain [C79.31], Reason for Study: ^Reason: Hx of single brain met from breast cancer s/p resection. Now with worsening headache on left side. Evaluate resection cavity, edema, and for additional mets History: Hx of rectal carcinoid cancer in 2011 and breast cancer in 2009. Previously described about 3.4cm x 2.5cm sized left middle frontal gyrus resection cavity is again seen. Pre contrast T1 weighted images show subtle somewhat patchy high signal intensity within the resection cavity which shows low signal intensity on T2 weighted images, thus indicating possible evolving blood products. Relatively thick susceptibility artifacts following the margin of resection cavity indicate postoperative blood products again much lessen than prior.Surrounding edema around the resection cavity also decreased in its extent since prior scan.On Gad enhanced scan, previously seen enhancing margin surrounding the resection cavity now shows lesser degree of enhancement. In addition, the enhancement pattern is smoother than prior which showed somewhat nodular enhancement. There is diffuse thick enhancement of overlying dura which likely represent postoperative changes. Overlying scalp swelling appears to be resolved.There is no evidence of new abnormal enhancing nodular lesion on this scan.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no restricted diffusion/acute ischemia. 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. Post resection status of the left middle frontal gyrus lesion with expected postoperative changes. 2. There is no evidence of residual mass.3. There is no new abnormal enhancement on this scan.4. There is no evidence of acute ischemic or hemorrhagic lesion.