History of lung cancer. Altered mental status. Examination demonstrates numerous enhancing lesions with surrounding vasogenic edema in the bilateral cerebral and cerebellar hemispheres and in the right cerebral peduncle. Some of the lesions appear hyperdense on the precontrast images. No significant mass effect, midline shift or abnormal extra-axial fluid collection is identified. The ventricles are normal in size and are symmetric.Incidental finding is a soft tissue lesion within the sella. After reviewing the prior MRI date dated 1/25/07, it is considered either an adenoma or cyst involving the pituitary stalk. Visualized paranasal sinuses and mastoid air cells are normally pneumatized. The calvarium is intact.
1.Multiple hemorrhagic metastatic lesions in light of the clinical history provided. 2.Likely an adenoma or cyst in the pituitary stalk.