Female, 55 years old, history of metastatic non-small cell lung cancer with confusion. Brain:Evidence of treated tumor is again seen within the far lateral left cerebellum and within the right cingulate gyrus. Both lesions show hemosiderin staining and neither lesion demonstrates any appreciable enhancement. Both are unchanged in size relative to the immediate prior examination, and much smaller when compared to earlier studies.A 4 mm enhancing focus within the inferior lateral left cerebellum and a 2 mm enhancing focus within the right inferior cerebellum are both unchanged. No new enhancing lesions are seen.No evidence of significant generalized mass effect is detected. No acute intracranial hemorrhage or any abnormal extra-axial fluid collections are observed. The ventricles are stable and normal in size. An incidental pineal region cyst is unchanged. Mucosal thickening is demonstrated in the paranasal sinuses and the mastoid air cells are partially opacified.C-spine:Sagittal alignment is anatomic. Vertebral body heights are preserved. No evidence of concerning marrow replacement, edema or pathologic enhancement is observed. The rectus capitis and obliquus capitis inferior muscles on the right are very slightly hyperenhancing. The visualized spinal cord demonstrates normal signal intensity throughout and is free of pathologic enhancement. No epidural abnormalities are suspected.C2-3: Unremarkable. C3-4: Unremarkable. C4-5: Right facet arthropathy. Minimal posterior disc-osteophyte complex formation. No spinal canal stenosis. Mild right foraminal narrowing. C5-6: Facet arthropathy. Posterior disc-osteophyte complex formation. Mild spinal canal narrowing. Moderate bilateral foraminal narrowing. C6-7: Unremarkable. C7-T1: Unremarkable.  A right pleural effusion is partially visualized.
1.No change in the size of treated tumors within the far left lateral cerebellum in the right fibula gyrus.2.Two additional enhancing lesions in the cerebellum also show no significant interval change.3.No evidence is seen to suggest metastatic disease to the cervical spine. Multilevel disc degeneration is evident most notably affecting C5-6 where there is spinal canal stenosis and significant bilateral foraminal narrowing.4.Mild hyperenhancement of the upper right posterior spinal paraspinal muscles may represent mild injury or inflammation.