74 years, Male, confusion, preoperative evaluation for brain tumor resection. Examination is limited to sequences for operative planning. Again seen is a heterogeneously enhancing mass with central necrosis centered in the left parietal lobe with extension into the left temporal lobe as well as the anterior aspect of the occipital lobe, similar to prior exam. Mass is again noted to extend to the ependymal surface and also noted to extend slightly across midline at the splenium. Mass measures approximately 5.0 x 4.3 cm in the axial plane and up to 5 cm in the craniocaudal dimension. There is surrounding edema and associated mass effect on the left lateral ventricle. There is also ventriculomegaly which is similar to prior. There is mild rightward midline shift. No uncal herniation. Evidence of recent left transparietal biopsy noted.
Heterogeneously enhancing mass with central necrosis centered in the left parietal lobe with extension into the left posterior temporal lobe, anterior occipital lobe, and slight extension across the splenium into the right parietal lobe. Appearance of the mass is consistent with a high-grade glioma neoplasm.