 The left superior parietal lobule enhancing lesion is persistently larger now measuring 7 x 7 mm, previously measured 5 x 4 mm The susceptibility abnormality seen previously is not as conspicuous on this exam which may be due to differences in slice selection. However, the FLAIR hyperintensity is more prominent. An additional punctate enhancing lesion is visualized just posteriorly within the left inferior parietal lobule, which is unchanged. The susceptibility abnormality in this lesion is also unchanged.The left middle frontal gyrus enhancing lesion is stable measuring 3 x 2 mm. This lesion also demonstrates mild susceptibility effect which is unchanged. The punctate focus of enhancement within the left lateral post central gyrus is also unchanged.The left anterior temporal lobe enhancing lesion is stable measuring 6 x 5 mm, but there is now less central enhancement. The susceptibility abnormality is increased compared to the prior exam.The right anterior inferior frontal gyrus enhancing lesion is similar in size measuring 6 x 5 mm. The surrounding FLAIR signal abnormality is also similar to the prior exam. An additional punctate enhancing lesion is noted in the right middle frontal gyrus that was less conspicuous previously and is unchanged.The lesion along the lateral aspect of the junction between the body and frontal horn of the right lateral ventricle, which was less conspicuous on the prior exam, now measures 6 x 6 mm compared to 4 x 5 mm previously.No new lesions. No significant mass effect, midline shift or herniation. There is no diffusion abnormality. There are no extraaxial fluid collections or subdural hematomas. Incidental note is made of a partially empty sella which is a normal variant. Moderate left frontal and anterior ethmoid sinus opacification. Bilateral maxillary retention cysts.
1.Interval increase in the size of the left superior parietal lobule metastatic lesion with mild increase in the surrounding FLAIR signal abnormality. 2.Interval increase in the size of a right lateral ventricle lesion, and likely represents an additional metastasis.3.Stable size of the remaining six lesions, several of which are punctate. No definite new lesions.