MR BRAIN WITH AND WITHOUT CONTRAST: 4/4/2023 4:23 PM
INDICATION (as provided by referring clinician): Melanoma, metastatic to other region
No iodinated contrast contraindication
Intracranial malignant neoplasm care
Repeat 3-month imaging needed for 58 y/o male undergoing nivolumab monotherapy for metastatic melanoma
ADDITIONAL HISTORY:
- 2010: metastatic NRAS mutant melanoma diagnosed with lung and brain metastases s/p multiple resections and multiple priorcourses of radiation treatment for brain metastases.
-10/12/2022: sterotactic surgery for progressive intracranial disease in the right temporal horn
- 12/5/2022: completed nivo and ipi, now on nivo monotherapy
COMPARISON: MRI brain on 12/21/2022
TECHNIQUE: Multiple sequences through the brain were acquired at 3.0 tesla.
MEDICATIONS:
Dotarem - 16.22 mL - Intravenous
FINDINGS:
Redemonstrated postoperative changes of prior right temporal and left parieto-occipital craniotomies with underlying resection cavities. Status post stereotactic radiosurgery involving the temporal horn of the right lateral ventricle. Similar-appearing nodular enhancement along the medial and posterior margins of the left occipital resection cavity and centrally within the temporal resection cavity. Increased fatty signal in the clivus and occipital condyles, likely representing postradiation change
No new areas of suspicious T2 hyperintensity, enhancement, reduced diffusion MR increased perfusion. Expected degree of abnormal susceptibility about the resection cavities.
Unchanged encephalomalacia and gliosis along the bilateral orbital frontal and anterior temporal lobes, likely sequela of prior trauma.
No acute hemorrhage. No herniation. No extra-axial collection.
IMPRESSION:
Compared to 12/21/2022, no evidence of disease progression.
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