Female, 58 years old, with GBM, IDH wild type. Findings related to multiple prior surgeries are again seen in the right temporal lobe. Again seen is a large rim-enhancing lesion occupying a majority of the anterior temporal lobe with extension into the insula and basal ganglia. On comparison with the immediate prior examination, the overall dimensions of this lesion have not significantly changed. The thickness of the enhancing rim has in some areas decreased which may reflect progressive necrosis.Generalized mass effect related to this lesion is unchanged. There is a stable midline shift to the left of approximately 6 mm. T2 hyperintensity spreading into the adjacent tissues reaching as high as the superior parietal lobule has improved in some areas. No new intracranial enhancing lesions are seen. Faint enhancement and diffusion restriction along the right atrial ependyma is probably unchanged. The size and shape of the ventricular system are unchanged. Periventricular T2 hyperintensity along the left lateral ventricle is unchanged and may be related to treatment.
The overall size of a large peripherally enhancing mass occupying the anterior right temporal lobe with extension into the insula and basal ganglia has not significantly changed from the immediate prior examination. The thickness of the enhancing rim has decreased which may indicate progressive necrosis. T2 hyperintensity surrounding this lesion has improved in some areas. No new intracranial lesions are appreciated.