70-year-old male with history of lung cancer. Evaluate for brain metastases.DUARTE, JORGE (DOB: 1/1/1946)PROVIDER/ATTENDING NAME: BACALAO, MARIA ALEJANDRA The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a 2 x 5 mm extra-axial dural based sessile enhancing lesion (series 1105, image 143) which is suspected to represent a very small meningioma. Additional punctate 3 mm enhancing focus within the right occipital bone (series 1105, image 44) is nonspecific. Otherwise there are no abnormal enhancing mass lesions appreciated within the brain parenchyma. No intracranial hemorrhage is identified. The gray-white matter differentiation is preserved There are several periventricular and subcortical white matter T2/FLAIR hyperintense foci.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.Mild mucosal thickening of the paranasal sinuses with likely a small mucous retention cyst in the right maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1. Suspect a very small meningioma overlying the left frontal lobe. Additional focus of enhancement within the right occipital bone is nonspecific. No abnormal enhancement is appreciated within the brain parenchyma.2. There are several periventricular and subcortical white matter lesions which are nonspecific. At this age they are most likely vascular related. 