Ring enhancing brain lesions carries multiple etiologies (mnemonics MAGIC DR). However, in elderly patients with posterior fossa brain lesion, the most likely differential diagnosis to consider is cerebral metastasis. It is easier to review the chest radiograph for any suspicious lung lesion to suspect lung carcinoma whenever we noticed any posterior fossa lesion, because lung carcinoma is one of the commonest malignancy with cerebral metastasis tendency, especially if the patient is chronic smoker.