58 years Male (DOB:12/8/1957)Reason: 58 yo M with metastatic SCC of H\T\N to brain s/p whole brain RT, eval for progression/response History: nonePROVIDER/ATTENDING NAME: STEVEN J CHMURA STEVEN J CHMURA There is redemonstration of multiple enhancing lesions within the brain parenchyma which have decreased in size since the prior exam. One located in the left frontal lobe currently measures 17 x 12 mm and previously measured 30 x 27. One located in the left middle frontal gyrus currently measures 8 x 7 mm axial dimensions and previously measured 22 x 16 mm axial dimensions. One in the left cuneus previously measured 13 x 16 mm and currently measures 9 x 11 mm axial dimensions. One in the right temporal lobe previously measured 23 x 16 mm and currently measures 15 x 10 mm axial dimensions. There are numerous other lesions are simple also decreased in size compared to the prior exam.There is redemonstration of a encephalomalacia in the right frontal lobeNormal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells demonstrate some opacities in the right mastoid air cells probably related to retained secretions which were not present on the prior exam.. The visualized portions of the orbits are intact.
1.Since prior examination lesions within the brain parenchyma compatible with metastatic disease have decreased in size but have not disappeared.2.There is encephalomalacia redemonstrated in the right frontal lobe.3.Retained secretions in the right mastoid air cells is nonspecific finding. Please correlate with clinical history and symptoms.