Male, 74 years old, history of lung cancer with unsteady ambulation. At least 10 enhancing parenchymal lesions are identified in the brain, most of which are supratentorial. They range in size from punctate up to 15 mm in diameter. Most are solidly enhancing but several show a centrally cystic morphology. The lesions are surrounded by mild edema and they induce mild local mass effect. These lesions are new when compared to the prior examination.No significant generalized mass-effect is seen. No evidence of intra-cranial hemorrhage or any abnormal extra-axial collection is identified. The ventricles are normal in size and morphology. Apart from the above-mentioned lesions, there are a few scattered punctate foci of T2 hyperintensity within the cerebral white matter which are nonspecific and unchanged.Marrow replacement and pathologic enhancement is seen at the right skull base involving the right occipital condyle and right mastoid temporal bone.
1. Numerous, at least 10, parenchymal metastatic lesions are seen, predominantly affecting the cerebral hemispheres. These lesions induce only mild local edema and mass effect. These are new when compared to the prior examination.2. Metastatic disease to the right skull base is seen involving the occipital condyle and the mastoid portion of the temporal bone.