Evaluate for abnormality/metastatic disease; history ovarian cancer. Brain: There is a peripherally enhancing mass in the medial left occipital lobe that measures up to 24 mm, with extensive surrounding vasogenic edema. There is also a heterogeneously enhancing mass in the right cerebellar hemisphere, which measures up to 15 mm, also with extensive surrounding vasogenic edema. There cerebellar tonsils extend up to 6 mm inferior to the foramen magnum. There is no evidence of intracranial hemorrhage or acute infarct. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.Complete Spine: There is fatty bone marrow signal in the lumbosacral spine related to radiation effects. There is also irregular linear low T1 signal and enhancement that traverses the right sacral ala. There are prominent sacral perineural cysts with remodelling of the sacrum. Otherwise, there is no evidence of mass lesions in the spine. There are mild degenerative changes in the lower cervical spine and at L5-S1 without significant spinal canal stenosis. The vertebral body heights are preserved. There is no significant spondylolisthesis. The spinal cord signal and morphology is normal. There is a right pleural effusion.
1. Metastases in the right cerebellar hemisphere and left occipital lobe with associated vasogenic edema.2. Radiation effects in the lumbosacral spine bone marrow with probable right sacral insufficiency fracture versus less likely an infiltrative metastasis.3. Low-lying cerebellar tonsils may represent Chiari 1 malformation.4. Right pleural effusion.