High-grade astrocytic neoplasm: interval worsening of left leg weakness. There has been increase in size of the heterogeneously enhancing right posterior frontal lobe mass and associated vasogenic edema since early December. Indeed, the mass now measures up to approximately 35 mm, previously 25 mm on 12/11/15. There are findings related to right transfrontal biopsy of the mass. There is mass effect upon the third ventricle, with slight increase in size of the lateral ventricles. There is also approximately 7 mm of midline shift to the left. There is persistent gyriform edema in the anterior temporal pole and insula without associated enhancement. There is no evidence of acute intracranial hemorrhage or acute infarct. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is a right maxillary sinus retention cyst.
1. Increase in size of the right posterior frontal lobe high-grade astrocytic neoplasm and associated vasogenic edema since early December with what appears to be incipient obstructive hydrocephalus of the lateral ventricles.2. Persistent gyriform edema in the anterior temporal pole and insula may be represent a form of encephalitis or non-enhancing infiltrative tumor. 