 Again demonstrated are post surgical changes related to left parietal lobe tumor resection with areas of increased T1 signal and susceptibility effects within the treatment cavity related to blood products. No abnormal enhancement to suggest recurrence. A small extra-axial fluid collection is seen which is less prominent along the left parietal convexity. The ventricles are normal in size. No mass effect or midline shift.There is mildly increased T2 signal which extends inferiorly within the periatrial region similar to previous.Previously demonstrated T2 hyperintense, enhancing mass in the left operculum demonstrates interval mild increase in size and slightly more heterogeneous enhancement on post gadolinium images relating to necrosis, overall measuring 3.7 x 2.7 x 3.1cm and previously 3.1 x 2.3 x 2.7 cm. Enlargement is more prominent when compared to 5/7/2015 study.Ventricles are normal in size. There is no mass effect or midline shift. The basal cisterns remain patent.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.
1. Compared to 5/7/2015 and 6/9/2015, there is continued enlargement of the left frontal operculum mass likely representing a separate focus of high-grade glial neoplasm. Increased necrosis within this tumor is also demonstrated.2. Stable postsurgical changes at the left parietal lobe resection cavity without discrete lesion to suggest recurrence at this site.