31-year-old male with a history of metastatic testicular cancer status post SRS. There is a new T1 hyperintense lesion in the right frontal lobe with susceptibility effect peripherally, measuring at least up to 13 mm. There are also new subcentimeter lesions with susceptibility effect in the left precentral gyrus, right occipital lobe, and right superior parietal lobe. There is redemonstration of two enhancing masses within the left frontal lobe. The left postcentral gyrus mass measures approximately up to 25 mm, which has slightly increased in size. However, the associated vasogenic edema has markedly improved. Likewise, there has been slight interval increase in size of the subcentimeter lesion with susceptibility effect within the left frontal lobe centrum semiovale, now with prominent central T1 hyperintensity, but decreased surrounding edema. There is T1 shortening and susceptibility within the metastatic lesions indicating intratumoral hemorrhage/hemosiderin. There is no evidence of acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. New hemorrhagic metastatic lesions in the left precentral gyrus, right frontal lobe, right occipital lobe, and right superior parietal lobe. 2. The treated left postcentral gyrus and left frontal centrum semiovale lesions are slightly larger, perhaps due to interval hemorrhage, but the associated vasogenic edema has diminished.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.