54 years, Female, brain metastases, surveillance Again seen is a punctate enhancing lesion in the left cerebellar hemisphere, post gadolinium 3-D series 903 axial image 49, measuring 2 mm and unchanged. No associated edema or hemorrhage. No new parenchymal or meningeal enhancement is seen. Again seen is a small resection cavity involving the left inferior parietal lobule without mass or enhancement to suggest recurrent tumor. There is susceptibility related to chronic blood products in this region. Surrounding FLAIR hyperintensity compatible with gliosis is also not significantly changed in the interval, although appears minimally more prominent which may reflect differences in technique. Minimal additional scattered T2/FLAIR hyperintense foci are nonspecific and not appreciably changed in the interval.A cavernoma with an associated developmental venous anomaly is again seen in the right parietal lobe showing no significant interval change. No evidence of hydrocephalus, intracranial mass effect, midline shift, or herniation.Again seen is an enhancing lesion involving the squamous portion of the right temporal bone, which demonstrates continued enlargement currently measuring 11 x 13 mm in the AP and transverse dimension, previously 6 x 9 mm on 7/26/2016. The lesion abuts the anterior aspect of the right superior temporal gyrus without significant mass effect.There is an enhancing lesion involving the C4 vertebral body which is incompletely evaluated but may represent osseous metastases.
1. Compared to 7/26/2016, there is no significant change in size of 2 mm left cerebellar enhancing lesion likely representing metastasis. No new parenchymal or meningeal enhancement.2. Continued enlargement of a right temporal calvarial lesion, now measuring 11 x 13 mm. Lesion abuts the anterior aspect of the right superior temporal gyrus without mass effect.3. Evidence of left parietal tumor resection without evidence of local recurrence.4. Stable right parietal cavernous malformation.5. Enhancing lesion involving the C4 vertebral body, post gadolinium sagittal 3-D T1 image 76, but is not imaged on prior studies and may represent an osseous metastasis. Bone scan may be considered to assess the burden of osseous metastatic disease.