Male 68 years old with metastatic follicular carcinoma of the thyroid to the brain s/p stereotactic radiosurgery to left cerebellar lesion 3 months ago, evaluate for new metastasis/progression Enhancing mass within the left cerebellum measuring approximately 14 x 12 x 11 mm, slightly decreased from prior 15 x 14 x 14 mm. The lesion again contains a minimal focus of susceptibility artifact, which may be related to minimal blood products. Surrounding area of T2/FLAIR hyperintense signal with minimal mass effect noted, which also appears decreased from prior exam. No new enhancing lesions identified.Mild age-related volume loss with prominence of the ventricles and sulci. Minimal foci of T2/FLAIR cerebral white matter signal similar to prior and compatible with minimal chronic small vessel ischemic changes. There is no evidence of acute intracranial hemorrhage or acute infarct on diffusion imaging. The pituitary gland appears unremarkable. The 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.
Mild interval decrease in size of metastatic left cerebellar lesion. There is also mild decrease in surrounding vasogenic edema. No new lesions.  