Brain metastases - breast cancer

Overlying the posterior left frontal and parietal lobes is a large heterogeneous enhancing mass with small areas of diffusion restriction and susceptibility signal dropout. It appears centered on the dura and has associated invasion into the overlying parietal bone, breaching the inner table with bony expansion and permeative change. No clear CSF plane between the mass and the posterior left frontal and parietal lobes, and in some areas loss of intervening cortical mantle. This may be secondary to brain invasion. Extensive hyperintense FLAIR signal tracks through the white matter with extension into the posterior body of the corpus callosum. Associated mass effect, with the septum deviated to the right and subfalcine herniation. The left cerebral peduncle is mildly compressed and displaced to the right. No transtentorial or uncal herniation. No ventricular entrapment.

Smaller enhancing extra-axial mass in the left middle cranial fossa, indenting the left anterior temporal lobe with adjacent vasogenic edema. Several small scattered T2/FLAIR hyperintense foci in the white matter of both frontal lobes which may reflect changes of chronic small vessel ischemia.

Small amount of mucoperiosteal reaction with partial opacification of the right sphenoid sinus. Lacrimal glands bilaterally are prominent but without enhancement or aggressive features.