Clinical question: Lung cancer with previous metastatic lesions treated with RT. Evaluate for disease. Signs and symptoms: Lung cancer. Enhanced CT of brain:There is redemonstration of the left-sided frontal extra-axial dural based enhancing tumor measuring 18.3 millimeter in AP access (sagittal reformatted image 35) and 18.9-mm in transverse axis measured on axial postinfusion image 22 these measurements are identical to prior MRI exam. These signal characteristic and pattern of enhancement as well as its location is highly suspected for a meningioma as it was noted on prior MRI. There is subtle buckling of the adjacent brain parenchyma however no vasogenic edema is detected. There is an enhancing well-demarcated mass in the right frontal lobe with extensive surrounding vasogenic edema. This tumor measures 14.1-mm in transaxial dimension (axial postinfusion image 21). On prior exam this tumor measured 5.6-mm in its transaxial dimension. There is no evidence of an additional metastatic lesions to the brain or the leptomeninges.Calvarium is intact. Visualized mastoid air cells, middle ear cavities are unremarkable. Visualized paranasal sinuses demonstrate complete opacification of right frontal sinus this finding was noted on prior MRI and CT exam.80 cc of Omnipaque 350 is administered for the study.
1.Dural based extra axial well-demarcated enhancing mass in high convexity left frontal lobe highly suspected of a meningioma. The measurement of the tumor are similar to prior MRI exam (18.3-mm in AP access and 18.9-mm in transverse axis).2.Significant interval increase in the size of a right frontal single metastatic focus which measures 14.1 x 14.1 millimeter in transaxial dimension.