Metastatic renal cell carcinoma follow up after treatment. There is no significant change in size of the enhancing lesion in the left precuneus, which measures up to 5 mm, previously also 5 mm. Likewise, the associated mild confluent surrounding T2 hyperintensity is not significantly changed. The enhancing right inferior temporal gyrus lesion has also decreased in size, which measures up to 3 mm, previously also 3 mm. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is a small amount of fluid in the mastoid air cells and retention cyst formation in the maxillary sinuses.
No significant interval change in size of the left parietal and right temporal lobe metastases.