NSCLC and brain metastases; June 2013 CyberKnife. There are three new supratentorial enhancing lesions with associated vasogenic edema. These include a left paracentral lobular lesion measures up to 4 mm, a right paracentral lobular lesion measures up to 8 mm, and a left occipital lobe lesion measures up to 6 mm. There is interval increase in size of a right lateral cerebellar hemisphere enhancing lesion and vasogenic edema, which measures up to 8 mm, previously 3 mm. There is also interval increase in size and enhancement of the previously treated right medial cerebellar hemisphere lesion, which now measures up to 10 mm. There is no evidence of acute intracranial hemorrhage or acute infarct. There is no midline shift or herniation. The ventricles and basal cisterns are unchanged in size and configuration. The major cerebral flow voids are intact. The skull, orbits, and scalp soft tissues are unremarkable. There is scattered paranasal sinus mucosal thickening.
New and enlarging supratentorial and infratentorial metastases with vasogenic edema, including the previously treated right cerebellar hemisphere metastasis, but no evidence of associated hemorrhage or midline shift.