Diagnosis: Malignant neoplasm of frontal lobeClinical question: preop planning for tumor removalSigns and Symptoms: seizures: preop planning The patient is status post left frontal lobe surgery for removal of a left frontal lobe mass. Since the prior exam from 6/17/2015 a new 18mm focus of T2 signal change has developed along the left fontal lobe at the anterior aspect of the left superior frontal gyrus at the inferior and anterior aspect of the surgical site. This now enhances heterogenously following contrast administration. It has not changed substantially in size since 10/21/2015.T2 signal change adjacent to and inferior and posterior to the surgical site remains stable when compared to the previous exams.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
Since the prior exam in June, a new focal lesion has developed at the anterior aspect of the left frontal lobe adjacent to the anterior and inferior margin of the surgical site which is suspicious for local recurrence. This has not changed substantially since the 10/21/2015 exam.