Malignant neoplasm of brain, unspecified [C71.9], Reason for Study: ^Reason: Eval GBM. This will be 3 mo post RT. History: GBM on TMZ There is no evidence of acute ischemic or hemorrhagic lesion.There is evidence of left parieto-occipital craniotomy with left occipital tissue defect associated with nodular wall enhancements. The tissue defect size is measured about 30.3mm (AP) x 28.3mm (RL) and 25.1mm (CC). In addition, there are scattered susceptibility artifacts on the peripheral aspect of the cavity and overlying brain surface indicating operation related blood products. At least 3 discrete nodular enhancing lesions are seen on the margin of the resection cavity which are measured about 7-8mm in longest diameter.In particular, there is a focal nodular enhancing lesion at the junction of the resection cavity and left lateral ventricle occipital horn. However, there is no evidence of associated adjacent ependymal enhancement. On FLAIR images, those enhancing lesions are associated with surrounding edema indicating possible residual or recurrent tumors. In particular, there is brain edema on the left corpus callosum splenium. The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Post resection and post radiation status of the left occipital GBM with at least 3 discrete enhancing nodular lesions on the resection margin as described above.2. Enhancing lesions on the resection margin could represent residual or recurrent tumor.3. No evidence of acute ischemic or hemorrhagic lesion.