Distal esophagus/gastroesophageal junction adenocarcinoma. Now with metastatic; was originally diagnosed in 1/2013 (s/p chemoRT, Ivor Lewis esophagectomy; cT2N1 -stage IIB in 5/2013). Study is at least mildly limited by patient motion. There is mild brain volume loss manifested by expansion of the ventricles and the other CSF-containing spaces. There are punctate T2 hyperintensities without diffusion restriction or mass effect in the frontoparietal white-matter, which are nonspecific but most likely from chronic microvascular ischemia. There is no space-occupying brain lesion. There is no midline shift or herniation. The major intracranial vascular flow voids are preserved, reflecting gross patency. There is no intracranial hemorrhage or abnormal diffusion restriction.There is no gross orbital abnormality. Minimal anterior ethmoid and maxillary sinus mucosal thickening is very nonspecific.
1.The study is mildly limited by patient motion and inability to complete the examination.2.No evidence of intracranial metastatic disease.3.Mild brain volume loss and trace frontal parietal chronic microvascular ischemia.