Metastatic melanoma status post 4 cycles Pembro. There are postoperative findings in the left temporal lobe with persistent confluent T2 hyperintensity diffusely along the margins of the resection cavity patchy enhancement along the medial aspect of the resection cavity. There is no evidence of acute intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues appear unchanged. There is a small defect in the left orbital floor.
Post-treatment findings in the left temporal lobe with persistent nonspecific patchy enhancement along the medial aspect of the resection. Otherwise, no new intracranial metastases are identified.