Melanoma. Right frontal lesion treated with laser ablation on 7/22/2014. Left occipital lesion treated with SRS on 10/22/2014. Again seen is a heterogeneous enhancing lesion in the right superior frontal gyrus that measures 12 x 7 mm similar to prior from 10/7/2014 and has been previously treated via laser ablation. Enhancing nodule within the left occipital lobe with intrinsic T1 hyperintensity at the grey-white matter junction is stable to minimally smaller compared to prior, measuring 3mm, previously approximately 4 mm. There is a right precentral gyrus developmental venous anomaly. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, consistent with minimal chronic small vessel ischemic changes. There is no midline shift or herniation. The ventricles and basal cisterns are normal in size and configuration. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable.
1. No significant change in size of enhancing right superior frontal gyrus lesion measuring up to 12 mm and consistent with treated metastasis (via laser ablation).2. Stable to slight decrease in size of enhancing left occipital lesion measuring 3 mm and consistent with treated metastasis (via radiation therapy).3. No new lesions or evidence of intracranial mass effect.