Findings:
There is a centrally necrotic intra-axial mass lesion within the right occipital pool measuring approximately 1.6 x 1.9 x 1.9 cm (AP x LR x SI). The mass is centered on the grey-white matter junction involving both cortex and subcortical white matter and has a broad dural abutment.
The solid components show diffusion restriction and enhancement on the postcontrast study. No central restricted diffusion in the mass. No haemorrhagic changes. Extensive surrounding vasogenic edema in the right occipital, temporal and parietal lobes with effacement of the sulci and the right lateral ventricle. There is no significant midline shift, and no hydrocephalus.
No evidence of any further enhancing lesions.
Moderate to advanced background small vessel ischaemic disease.
The pituitary gland is normal.
Mucosal thickening is seen within the ethmoid and maxillary sinuses bilaterally. The paranasal sinuses and mastoid air cells are otherwise clear.
No bony abnormality is seen. The craniocervical junction is normal.
Conclusion:
Right occipital, intra-axial mass with extensive vasogenic oedema, most likely representing a metastasis.
Further evaluation with CT thorax/abdomen/pelvis and neurosurgical referral is advised.