Esophageal cancer. There is slight interval decrease in size of the mass in the left temporo-occipital region, now measuring up to 21 mm, previously 23 mm. Likewise, there is significant change in size of the left frontal lobe lesion, now measuring up to 14 mm, previously 14 mm, although the extent of surrounding vasogenic edema has increased. In addition, the right frontal lobe lesion is not discernible. There is no evidence of acute intracranial hemorrhage or acute territorial 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, orbits, and scalp soft tissues are unremarkable. However, there is persistent fluid within the bilateral middle ears and mastoid air cells and mild scattered paranasal sinus mucosal thickening.
1. Slight interval decrease in size of the temporo-occipital region, but no significant interval change in size of the left frontal lobe lesion, although the associated vasogenic edema has increased. The right frontal lobe lesion is not discernible.2. Persistent nonspecific effusions within the bilateral middle ears and mastoid air cells, which may represent otomastoiditis.