Metastatic lesion, 3 month follow-up. Again seen are postsurgical changes of left frontal and left temporal craniotomy for tumor resection. There is encephalomalacia involving the left frontal lobe with T2/FLAIR hyperintensity compatible with gliosis which is unchanged. There is extra-axial dural based thickening in the surgical bed measuring 11 x 25 mm in the axial plane and up to 11 mm in the cranial caudal dimension which remains unchanged. Again seen is an area of increased T2/FLAIR signal in the cortex and subcortical white matter of the left anterior temporal lobe corresponding to site of prior tiny ring enhancing lesion, and is unchanged from the prior exam. No new mass or mass-effect. No abnormal parenchymal or abnormal meningeal enhancement elsewhere in the brain is seen. No hydrocephalus. No evidence of acute ischemia or hemorrhage. Major flow-voids are preserved. Sella and orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear.
1.Stable postoperative changes related to resection of a metastatic lung cancer lesion with stable areas of encephalomalacia/gliosis in the anterior left frontal lobe. Adjacent extra-axial enhancing area remains unchanged and likely represents scarring.2.No new enhancing foci to suggest disease recurrence or new metastatic lesion. 3.Unchanged T2/FLAIR hypointensity in the anterior left temporal lobe, in location of a previously ring enhancing lesion.