72-year-old female with small cell lung cancer. Evaluate for metastasis. There are at least 12 enhancing lesions seen within the bilateral cerebral hemispheres and cerebellum. Many of these are very close to the or at the cortical surface concerning for involvement of the subarachnoid space. There is no definite cranial nerve enhancement. The lesions are all small with the largest along the medial aspect of the right middle cerebellar peduncle measuring 11 x 10 mm (series 10, image 54). Some of these lesions demonstrate mild surrounding T2 signal abnormality and 1 or 2 of these lesions produce very mild edema. There is no evidence of acute intracranial hemorrhage or hemorrhagic involvement of any of the lesions. Extensive underlying periventricular and subcortical white matter T2/FLAIR hyperintensity is seen most likely related to chronic small vessel ischemic disease. 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.
Numerous, at least 12, enhancing intracranial lesions are seen compatible with metastatic disease.