51 years, Female, metastatic renal cell carcinoma, post stereotactic radiation therapy, follow-up evaluation. Again seen is an enhancing lesion involving the right cerebellar hemisphere measuring 15 x 14 x 11 mm in the AP, transverse, and craniocaudal dimensions, previously 11 x 9 x 9 mm on 4/20/2015. There is a second lesion involving the right subinsular white matter abutting the putamen measuring 4 x 5 x 6 mm and also slightly larger, previously approximately 4 mm in diameter. There is associated susceptibility effect consistent with chronic blood products associated with the lesion and increased since 4/20/2015. There is also mild increase in surrounding FLAIR hyperintensity compatible with vasogenic edema. No significant mass effect, midline shift, or herniation. No hydrocephalus. No restricted diffusion to suggest acute ischemia. No abnormal meningeal enhancement. Major flow-voids are preserved.Small right maxillary mucus retention cyst. Paranasal sinuses and mastoid air cells appear otherwise clear. Bone marrow signal and extracranial soft tissues are within normal limits.
Compared to 4/20/2015 and 5/8/2015, there has been mild interval enlargement of enhancing lesions involving the right cerebellar hemisphere (which has been previously treated) as well as a smaller lesion involving the right subinsular white matter. There is mild increase in associated blood products and mild increase in associated edema.No significant mass effect, midline shift, or herniation. No hydrocephalus. 