Glioblastoma status post resection and chemoradiation. There are postoperative findings related to right frontotemporal craniotomy. There is no significant change in the irregular peripherally-enhancing mass in the right temporal, with apparent elevated perfusion in the enhancing component, although, the extent of adjacent ependymal enhancement has increased. There is no significant interval change in the irregular peripherally-enhancing mass in the right frontal lobe, but the more lateral adjacent solidly-enhancing tumor has decreased in size. The presence of susceptibility effect in this region limits assessment of the perfusion characteristics. However, there is increased surrounding confluent white matter T2 hyperintensity with associated slight increase the right uncal herniation and effacement of the right lateral and third ventricles since December 2015. There is 6 mm of midline shift to the left. There is no evidence of acute intracranial hemorrhage or infarction. There is unchanged nonspecific patchy cerebral white matter hypoattenuation in the left cerebral hemisphere. The orbits, paranasal sinuses, and scalp soft tissues are grossly unchanged.
1. No significant change in the irregular peripherally-enhancing mass in the right temporal, with apparent elevated perfusion in the enhancing component, although, the extent of adjacent ependymal enhancement has increased2. No significant interval change in the irregular peripherally-enhancing mass in the right frontal lobe, but the more lateral adjacent solidly-enhancing tumor has decreased in size. 3. Confluent white matter abnormality surrounding the tumor foci has increased since December 2015, which may represent tumor infiltration and/or edema related to treatment.