Secondary malignant neoplasm of skin [C79.2], Reason for Study: ^Reason: leptomeningeal spread History: metastatic breast CA Re-demonstration of multiple extra axial enhancing metastatic lesions involving skull and leptomeninges. Overall the enhancing lesions show a bit smaller than prior scan. In particular, the left parietal and midline occipital adjacent to torcular show significant decrease in size since prior scan. Leptomeningeal enhancement is again demonstrated without any significant interval change since prior scan.Previously seen left parietal lobe lesion, does not show any significant interval changes since prior scan. There is no other intra axial lesion on this scan.There is no evidence of acute ischemic or hemorrhagic lesion. 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. Overall decrease in size of multifocal extra-axial (skull and scalp) metastatic enhancing nodule since prior scan, especially significant decrease in size of left parietal and midline occipital lesions.2. No significant interval change of leptomeningeal and enhancement since prior scan.3. No MR evidence of intra-axial metastatic lesion.