Male, 53 years old, with history of metastatic renal cell carcinoma, status post radiation to two right frontal lobe lesions, one right cerebellar lesion and one left cerebellar lesion in 10-2015. Evaluate new left-sided lesion. Again seen is evidence of right frontal craniotomy and cranioplasty. Sequelae of prior tumor resection and treatment are redemonstrated within the right frontal lobe showing no significant interval change. There is no pathologic enhancement in the treatment bed and the degree of encephalomalacia and parenchymal T2 hyperintensity is unchanged.A punctate focus of enhancement within the right parietal subcortical white matter (image 127 series 13) is unchanged from prior. A punctate focus of enhancement within the left cerebellum (image 54 series 13) is also unchanged from prior. No other parenchymal enhancing lesions are seen. Two foci of susceptibility, one in the right cerebellum and one in the left, are unchanged and likely represent a treatment related effect. A few scattered additional foci of nonspecific parenchymal T2 hyperintensity are unchanged. The ventricles are stable in size and morphology including ex vacuo dilatation of the right frontal horn.A 12 mm enhancing lesion within the left posterior parietal bone is unchanged when compared to the immediate prior examination but has increased in size when compared to older studies.
1.Stable postoperative and treatment related findings in the right frontal lobe.2.Stable punctate foci of susceptibility in the cerebellar hemispheres likely related to treated lesions.3.Punctate foci of enhancement within the right parietal lobe and in the left cerebellum are unchanged and nonspecific.4.A 12 mm enhancing lesion in the left posterior parietal bone is stable when compared to the immediate prior study but has increased in size relative to older exams compatible with a metastatic focus.