50 years, Male, lethargy, gait instability, history of malignancy. Additional history per chart, patient has history of HIV and metastatic NSCLC. There is a 7 mm enhancing nodule involving the lateral aspect of the splenium on the left which is contiguous with asymmetrically prominent enhancement of the left choroid plexus. The lesion including the intraventricular component is best seen on sagittal post gadolinium reformatted series 1103 image 74 where it measures up to 13 x 13 mm in the AP and craniocaudal dimensions. There is mild adjacent parenchymal FLAIR hyperintensity compatible with vasogenic edema. There is no significant intracranial mass effect. No midline shift or herniation. Moderate degree of motion degradation limits sensitivity to small lesions elsewhere in the brain however no additional lesions are definitively appreciated within this limitation. Subtle areas of enhancement along the left lateral ventricle wall are not well evaluated but may represent normal vasculature. Cavum septum pellucidum and cavum vergae incidentally noted. No hydrocephalus. No findings to suggest acute infarct or parenchymal hemorrhage, with small focus of susceptibility effect within the medial intraventricular component of the lesion which may represent minimal blood products or perhaps mineralization. Mild global parenchymal volume loss.
1. 13 x 13 mm enhancing lesion involving the left lateral ventricle choroid plexus and adjacent splenium of the corpus callosum is suspicious for metastasis. No additional lesions are definitively appreciated within the limitations of motion degradation. Patient had difficulty tolerating the examination due to pain.2. Mild surrounding edema associated with the above lesion. No significant intracranial mass effect.