Female, 69 years old, with history of adenocystic carcinoma of the left lacrimal gland, diagnosed in 2014 at an outside hospital, status post resection and flap reconstruction. Subsequent complications included flap failure and infection. Left maxillary and orbital resection is seen with evidence of soft tissue and bony flap repair. Although this is not a dedicated examination for the facial soft tissues, and without the benefit of a prior examination for comparison, no definite suspicious soft tissue is seen within the operative bed.Multiple areas of periventricular T2 hyperintensity are seen, some of which demonstrate a relatively linear morphology with respect to the ventricular surface. No evidence of restricted diffusion or parenchymal edema is seen. No mass effect is identified. No pathologic intracranial enhancement is observed. The ventricles are of normal size and morphology. No evidence of acute intracranial hemorrhage or any other abnormal extra-axial fluid collection is seen.
1.White matter lesions are identified in the brain with a distribution and morphology compatible with demyelinating disease.2.No evidence of any acute parenchymal edema, mass effect or pathologic enhancement is seen to suggest intracranial metastatic disease.3.Extensive postsurgical findings are demonstrated compatible with left maxillary and orbital resection with soft tissue and bony flap reconstruction. 