Metastatic breast cancer needs evaluation per IRB 14-0701. There is a heterogeneously enhancing mass in the right perirolandic region that measures up to 25 mm. There is associated vasogenic edema and mild regional mass effect. There is also an area of susceptibility effect within the mass that has a configuration suggestive of an underlying developmental venous anomaly, although this could alternatively represent intratumoral hemorrhage or calcification. There is also enhancing lesions in the left occipital lobe that measures up to 5 mm. There is a background of mild cerebral white matter T2 hyperintensity, which may represent chronic small vessel ischemic disease. There is no evidence of acute infarct. The ventricles and basal cisterns are normal 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 are unremarkable.
Enhancing lesions within the right perirolandic region and left occipital lobe likely represent metastatic disease to the sulci may suggest normal pressure hydrocephalus.