Male 59 years old History: atypical meningioma. Grade II meningioma status post resection in 2010 and again in 2016, as well as SRS. There are post-treatment findings related to right parietal craniotomy and radiation therapy. There is interval increase of dural based tumor in the treatment bed region. For example, a lesion along the right lateral parietal convexity measures up to 9 mm in thickness, previously 5 mm, a nodular dural based tumor along the posterior occipital convexity measures up to 10 mm, previously 5 mm, and tumor along the lateral occipital convexity with infiltration of the calvarium measures up to 12 mm in thickness, previously 8 mm. There is persistent high T2 signal and scattered areas of gyriform enhancement in the posterior parietal lobes near the midline, which is not significantly changed. There is no evidence of acute cerebral infarction. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. There is a partially-empty sella. The skull and extracranial soft tissues are unchanged.
1.Postoperative findings in the right parietal region with increase in size of multiple foci of residual tumor in the treatment bed. 2.Unchanged treatment effects in the bilateral posterior cerebral hemispheres likely related to radiation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.