 Contrast enhancing mass lesion in the left frontal lobe measuring 2.9 x 2.3 cm (axial post contrast image 231). Significant associated vasogenic edema with mass effect on the anterior horn of the lateral ventricle and genu of corpus callosum. Mild rightward subfalcine herniation. This lesion extends to the surface of the cortex with mild dural enhancement, likely reactive. There is another lesion in the right cerebellum measuring 1.8 x 2.3 cm (axial post contrast image 67) with mild deformity of the fourth ventricle contour. There is also left parietal lesion measuring 1.1 x 0.8 cm (axial post contrast image 213). There is minimal susceptibility artifact associated with these lesions compatible with minimal blood products. There is also punctate 4-mm lesion in the posterior aspect of the right inferior temporal gyrus at the occipital junction. No evidence of hydronephrosis. Nonspecific mild diffuse low T1 intensity of the bone marrow without discrete enhancing lesion. No evidence of leptomeningeal disease. No extra-axial fluid collection. Contrast enhancement and flow voids of major vessels indicating patency. The imaged paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable.
Intracranial metastatic disease with four enhancing lesions as detailed above. The dominant left frontal and right cerebellar lesions have significant associated vasogenic edema and local mass-effect. Mild rightward subfalcine herniation. No transtentorial herniation. No hydrocephalus. 