Male, 44 years old, history of metastatic melanoma status post two cycles of Temodar. Assess response to therapy. Numerous enhancing parenchymal lesions are again seen, most of which have substantially decreased in size compared to the prior examination. Some of the larger lesions also show reduced edema. For example, a lesion along the left posterior insula now measures 6 x 3 mm, previously 10 x 7 mm. Likewise, a lesion along the right superior temporal sulcus measures 4 x 4 mm, previously 9 x 6 mm.A few lesions have not significantly changed in size but these represent the minority. No definite growing or new lesions are seen. As before, some of the lesions demonstrate hemosiderin staining compatible with blood product, particularly one along the left precentral gyrus, while others show intrinsic T1 hyperintensity which may reflect either blood product or melanin.No acute intracranial hemorrhage is suspected. No abnormal extra axial fluid collections are detected. The ventricles are stable and normal in size.
Interval response to treatment with a majority of the previously seen enhancing lesions showing a substantial reduction in size.