Female, 63 years old, with metastatic lung cancer, EGFR positive, status post SRS, status post four cycles of Erlotinib and MPDL3280A. Also with history of prior surgery for meningioma. A 2 mm focus of enhancement within the right cerebellar hemisphere is unchanged. No other parenchymal enhancing lesions are seen.A small area of nodular and plaque-like extra-axial enhancement is seen at the left anterior clinoid process with tapering extension along the left planum sphenoidale and into the left aspect of the sella and cavernous sinus (see image 15 and image 14, series 1201). This finding is unchanged over both prior MRI examinations.Encephalomalacia of the left inferior frontal lobe is unchanged. Metallic artifact obscures a portion of the left frontal calvarium and left frontal lobe similar to prior.A slitlike fluid space is evident within the left basal ganglia, stable from prior, perhaps simply representing a perivascular space. A few additional scattered small foci of white matter T2 hyperintensity are redemonstrated, nonspecific and unchanged.No parenchymal edema or significant parenchymal mass effect is detected. No intracranial hemorrhage or any abnormal extra-axial collections are seen. The ventricular system is normal in size and morphology.
1. No significant change is seen in the size of a 2 mm focus of enhancement within the right cerebellum. No new parenchymal enhancing lesions are detected on this exam.2. A region of nodular and plaque-like extra-axial enhancement is seen centered at the left anterior clinoid process with extension along the left planum sphenoidale and into the left sella and cavernous sinus. This lesion has not changed significantly over the two prior examinations and is favored to represent a meningioma. Encephalomalacia within the adjacent left frontal lobe likely relates to prior surgical treatment of this lesion.