 There is heterogeneously enhancing lesion in the left inferior cerebellar hemisphere measuring transaxial 25 x 11 mm, and 22 mm AP with central hypoenhancement and speckled foci of internal enhancement, and a rim of irregular but somewhat more linear enhancement. While this lesion is without significant change from March 2015, it has increased in size from November 2014 where it measured 18 x 8 mm transaxial. There are a few small foci of susceptibility effect within this region which appear more prominent, and moderate surrounding T2 prolongation outlining the left dentate nucleus which is stable from more recent exam but worsened from November 2014, most likely representing combination of vasogenic edema and/or post treatment changes. There is regional mass effect with effacement of the regional cerebellar folia.There is a more prominent 8 mm nodule of enhancement in the right anterior temporal lobe without significant surrounding edema or mass-effect. This lesion measured approximately 6 mm on March 2014 exam, and is new from November 2014 exam.The flow-voids of the skull base are intact.
1.Prebiopsy exam showing heterogeneously enhancing lesion with surrounding nonspecific T2 signal abnormality in the left inferior cerebellar hemisphere which is similar to more recent outside exam from March 2015, but larger compared to November 2014 exam.2.Right anterior temporal lobe 8 mm nodular enhancement consistent with metastasis, worsened from March 2015 and new from November 2014.