59 years Female (DOB:1/10/1957)Reason: Metastatic breast cancer History: restagingPROVIDER/ATTENDING NAME: MURTUZA M RAMPURWALA MURTUZA M RAMPURWALA The CSF spaces are appropriate for the patient's stated age with no midline shift. The patient is status post left parietal craniotomy for removal of a left frontal lobe mass involving precentral gyrus as well as portions of the adjacent superior frontal gyrus left middle frontal gyrus. There is now a hemorrhagic cavity at the site of the prior neoplasm. This cavity has decreased in size when compared to the November/7/16 exam. This cavity currently measures 18 x 20 mm and previously measured 35 x 30 mm. There is less vasogenic pattern of edema associated with it on the current exam when compared to the prior exam. There is contrast enhancement along the margins of the tumor resection site.A hemorrhagic lesion is present in the left occipital lobe. The T1 hyperintense component measures approximately 13 mm diameter. The measurements on T2 imaging are approximately 10 mm x 19 mm axial dimensions. It was not present on the 11/1/2016 exam or the 11/4/2016 exam but was present on the 11/7/2016 exam where it represented a larger hemorrhage measuring 29 x 17 mm axial dimensions on T2 imaging at that time.There is redemonstration of a developmental venous anomaly in the right occipital lobe which is associated with some vague enhancement along the cortex. This appearance is stable compared to the prior exam.There is a developmental venous anomaly present in the right cerebellar hemisphere which is also stable compared to prior exam.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate some mild mucosal thickening in the left maxillary sinus.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Since the previous exam the cystic cavity at the tumor resection site the left frontal lobe has decreased in size. Some enhancement along the margins of the tumor resection site could represent postoperative change. Follow-up examination would help confirm this.2.A hemorrhage in the left occipital lobe has decreased in size compared the prior exam.3.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 4.There is a developmental venous anomaly present in the right occipital lobe associated with some vague enhancement. The possibility this represents capillary telangiectasia associated with a developmental venous anomaly is raised. It is stable compared to prior exams.5.There is a developmental venous anomaly in the right cerebellar hemisphere.