Secondary malignant neoplasm of brain [C79.31], Reason for Study: ^Reason: h/o metastatic breast ca to brain s/p SRS to R medial, R post-central gyrus lesions and most recently L frontal middle gyrus lesion History: eval for extent of disease There are two new enhancing nodules on this scan indicating possible metastatic nodules.One is one the at the junction of right frontomarginal gyrus and right lateral orbital gyrus (series 12, image 69/168) and another one is at the left superior parietal lobule around the cranial end of the post central sulcus (series 12, image 49/168). There is no evidence of acute ischemic lesion on this scan.The right frontal lobe precentral gyrus lesion which is close to the paracentral lobule does not show any evidence of enhancement. It does show susceptibility effects on gradient echo images but without surrounding edema or mass effects indicating hemosiderin deposition (chronic hemorrhagic lesion) which is unchanged since prior scan.The left middle frontal gyral lesion which was seen on Feb 3 2015 is not shown on today's scan.The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. 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. Two new enhancing nodules one on the right frontal lobe and another on the left parietal lobe as detailed above indicating possible new metastatic nodules.2. Chronic hemorrhagic lesion on the right precentral gyrus close to paracentral lobule without evidence of enhancement, no change since prior scan.3. Previously seen (Feb 3 2015) left middle frontal gyral lesion is not demonstrated on today's MRI.4. No abnormal enhancement is seen.5. No evidence of acute ischemic or hemorrhagic lesion.