Metastatic head and neck caner with suspicious lesion on head CT. There are at least six bilateral cerebral hemisphere nodular and ring-enhancing lesions with minimal to mild vasogenic edema. For example, the largest measures up to 9 mm in the left middle frontal gyrus, which appears to be smaller and associated with diminished edema compared to the prior CT, accounting for difference in technique. There is also a punctate enhancing lesion in the left cerebellar hemisphere. In addition, there are multiple enhancing lesions within the skull, the largest of which measures up to 25 mm in the occipital bone with minimal associated enhancement of the overlying subgaleal tissues, but no evidence of epidural extension. There is no evidence of acute intracranial hemorrhage or cerebral infarction. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is minimal fluid within the left mastoid air cells. The orbits are unremarkable.
1. Several subcentimeter supratentorial and infratentorial subcentimeter lesions are compatible with metastases.2. Multiple skull lesions are also compatible with metastases.