Female, 81 years old, with metastatic breast cancer and dural based metastasis, status post radiation treatment. The previously seen dural based plaque-like enhancing lesion along the clivus is redemonstrated. Since the prior examination, the lesion has decreased in size now measuring up to 15 mm in the craniocaudal dimension (previously 19 mm) and up to 6 mm in thickness (previously 9 mm).No additional new dural enhancing lesions are seen and no pathologic parenchymal enhancement is detected. Scattered foci of white matter T2 hyperintensity are unchanged and nonspecific. No evidence of any abnormal extra-axial fluid collection or acute intracranial hemorrhage is observed. The ventricular system is stable and normal in size.Numerous foci of marrow replacement are redemonstrated involving the entire visualized calvarium and upper upper cervical spine. As before, some of the calvarial lesions violate the cortex. No significant interval change from the prior examination is suspected.
1.Decrease in size of a plaque-like dural based tumor along the clivus likely representing response to treatment.2.Redemonstrated is extensive osseous metastatic disease without significant interval change.3.No evidence of parenchymal metastatic disease.