Diagnosis: Secondary malignant neoplasm of brainClinical question: hx met lesion, radiation necrosis- Baseline evaluation post opSigns and Symptoms: none- surveillance The patient is status post left-sided craniotomy. There is adjacent dural thickening present and blood products. A previously noted mass in the left inferior parietal lobule is not readily identified on the current exam. Instead there is a small amount of enhancement associated with the susceptibility effect indicative of postsurgical change.There is a 6 mm ring-enhancing lesion present along the left superior parietal lobule just behind the left postcentral gyrus. This measured 8 mm on 5/29/2015 and 6 mm on the 6/23/2015 exam.There is redemonstration of a 3 mm enhancing longitudinal along the lateral aspect of the right orbital gyrus. This area is obscured on susceptibility weighted imaging.A 2 mm minimal nodule is redemonstrated at the frontal horn of the right lateral ventricle. It is no longer visible on the current postcontrast exam and was more conspicuous on prior exams. It is associated with the susceptibility effect and is more conspicuous on the susceptibility weighted images on the current exam.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate scattered opacities. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.There is a small lesion present in the left parietal lobe which remains stable when compared to prior exams.2.The patient has undergone surgical removal of a left inferior parietal lobule mass.