59 year old female patient with metastatic lung cancer on erlontinib. A small enhancing focus within the anterior left temporal lobe measures approximately 3 mm, previously 4.5 mm. No new enhancing intraparenchymal lesions are identified. There is no pachymeningeal or leptomeningeal enhancement. Multiple scattered foci of susceptibility artifact appear similar to the prior study may reflect prior treated metastases or chronic blood products. Scattered subcortical and periventricular abnormal T2 signal may represent chronic small vessel ischemic disease. There are no new diffusion-weighted abnormalities to suggest acute ischemia. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. The left mastoid air cells are fluid-filled. A 5 mm enhancing focus within the left retro-orbital soft tissues is unchanged. Multiple heterogeneously enhancing calvarial lesions are similar in size and appearance compared to the prior study.
1. Slightly smaller to stable enhancing left temporal lobe metastatic lesion without new enhancing intraparenchymal lesion. 2. Stable left retro-orbital enhancing lesion and multiple calvarial lesions.