Female, 53 years old, with history of grade III oligodendroglioma with 1p19q deletion, s/p surgery, proton beam RT, and now on TMZ. Redemonstrated is evidence of right frontal lobe tumor resection. The surgiccal cavity is unchanged in size and morphology. Dural thickening along the craniotomy is expected and stable. Continued interval reduction is seen in the amount of wispy curvilinear enhancement along the posterior cavity margin, likely post-operative in nature. Heterogeneous thickened tissue which remains in the left frontal lobe, extending into the genu of the corpus callosum, had also not significantly changed. No new parenchymal thickening or pathologic enhancement is seen.Ill defined T2 hyperintensity has progressed bilaterally in the centrum semiovale, more so on the left. These areas are associated with no mass effect and no elevated rCBV. The changes are therefore likely related to treatment.No new mass effect or edema is seen. No new intracranial hemorrhage or fluid collections are seen. The ventricular system is patent and stable in size.
Mild progression of white matter signal abnormality most compatible with treatment effect. No evidence of tumor progression is seen.