71 years, Male, stage II/III melanoma. High risk of recurrence, restage. There is no intracranial mass or abnormal parenchymal or meningeal enhancement to suggest metastatic disease. There is a encephalomalacia involving the left frontal lobe, primarily involving the left middle frontal gyrus, with cystlike cavity and surrounding FLAIR hyperintensity related to gliosis. There is susceptibility along its medial aspect which may reflect hemosiderin deposition from prior hemorrhage or mineralization. No restricted diffusion to suggest acute ischemia. No intracranial mass-effect, midline shift, or herniation. The ventricles are within normal limits in size. Minimal additional scattered foci of T2/FLAIR hyperintensity in the bilateral subcortical and periventricular white matter are nonspecific, but compatible with very mild chronic small vessel ischemic changes. Brain parenchyma is otherwise unremarkable for age. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are grossly unremarkable.
1. No evidence of intracranial metastatic disease.2. Left frontal lobe encephalomalacia, which may relate to chronic infarct or other remote injury.