Evaluate depth of scalp melanoma. Brain: There is an enhancing nodular lesion involving the epidermis and dermis of the left parietal scalp that measures up to 12 mm in width and 9 mm in depth. There is also mild thickening and hyperenhancement of the periosteum deep to the lesion, but there is no discernible signal abnormality in the underlying calvarium. The superficial aspect of the lesion is slightly indented, which may be related to prior biopsy. There is a prominent left occipital scalp lymph node that measures up to 10 mm in length. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable.Neck: There is no evidence of measurable mass lesions or significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The osseous structures are unremarkable.
1. A left parietal scalp lesion that corresponds to the biopsied melanoma measures up to 12 mm in width and 8 mm in depth and involves both the epidermis and dermis. While there is nonspecific mild periosteal reaction deep to the lesion, the underlying calvarium appears to be grossly intact. 2. A prominent left occipital scalp lymph node is nonspecific.3. No evidence of cervical lymphadenopathy.