 There is no significant change in size of of the predominantly cystic craniopharyngioma measuring up to 45 mm in the maximal AP dimension and 42 mm in the transverse dimension, similar to prior. There continues to be involvement of the suprasellar, prepontine, cerebellopontine angle, right ambient and right quadrigeminal cisterns, as well as the right middle cranial fossa, with associated mass effect upon the brainstem, right medial temporal lobe, and hypothalamus-optic apparatus complex. Areas of enhancement in the suprasellar cistern are not significantly changed. T1 shortening which may reflect proteinaceous material or blood products in the right ambient cistern also not significantly changed. No enlarging components. Leftward displacement of the pons and contour deformity involving the right lateral aspect of the midbrain is not significantly changed. There is no new mass effect. Again seen are foci of susceptibility effect within the right temporal lobe resection cavity, consistent with hemosiderin deposition, and within portions of the tumor particularly in the suprasellar cistern, which likely represent calcifications.Parenchymal defect/encephalomalacia in the right lateral temporal lobe is unchanged. There is unchanged volume loss of the left cerebellar hemisphere associated with increased T2 signal, which may be attributable to crossed cerebellar diaschisis versus chronic injury. T2/FLAIR signal abnormality in the left medial temporal lobe which may reflect posttreatment change is also unchanged. The basilar artery is tortuous and encased by the tumor. There is stable position of right transfrontal catheter with the tip in the right prepontine cyst. The ventricular system also appears unchanged without hydrocephalus.
Compared to 8/18/2016, there is no significant interval change in size of the treated craniopharyngioma.