Technique: Multiplanar, multisequence imaging has been obtained through the brain including pre and post contrast sequences.
Findings: An irregular multicystic mass with peripheral nodular enhancement is demonstrated within the superomedial left cerebellar hemisphere. The overall lesion dimensions are 23 x 29 x 28mm (AP x trans x CC). There is moderate mass effect on the adjacent cerebellar hemisphere and vermis with FLAIR hyperintensity, as well as compression of the fourth ventricle. No hydrocephalus at this stage. No tonsillar herniation. The lesion does not demonstrate prominent flow voids.
An 8mm ill-defined enhancing FLAIR hyperintense focus is demonstrated at the superolateral margin of the body of the left lateral ventricle. This does not cause significant mass effect. There is also an 8mm homogeneously enhancing extra-axial lesion abutting the anterior falx to the left of midline. Post contrast T1 volumetric acquisition through the brain for the purposes of stereotaxis has also been obtained.
Conclusion: Cystic left cerebellar lesion with mass effect is most consistent with a metastasis. The enhancing focus adjacent to the left lateral ventricle is favoured to also represent a metastatic deposit. The left parafalcine lesion likely represents a meningioma (metastasis less likely).