52 year old patient with thyroid cancer. Metastatic brain lesion. History of tumor resection and radiation. Tumor recurred and current trauma patient complains of increasing headaches and probable determining things. Nonenhanced head CT:There is a new interval area of extensive vasogenic edema in the left frontal lobe near the site of previously noted metastatic lesion on prior exam from 12 -- 13 -- 2010. This finding is associated with mass effect and effacement of adjacent cortical sulci as well as mass effect on the left frontal horn of the left lateral ventricle and midline shift of approximately 8 mm at the level of septum pellucidum. The finding is highly concerning for metastatic lesion and recommend follow with a dedicated enhanced MRI of brain. There are no additional foci of abnormal density of brain parenchyma. Ventricular system are within normal range of size.Above findings were discussed with the clinical service Dr. Postma Kelly at the time of interpretation of the exam.
Large new focus of vasogenic edema in the left anterior frontal lobe with associated mass effect. Recommend follow up with enhanced CT or an enhanced MRI for evaluation of metastatic disease. Rightward midline shift of approximately 8 mm.