73-year-old female with history of recurrent/progressive GBM status post resection and radiation Again seen are post operative changes of a right posterior temporal-parietal craniotomy. Surgical resection cavity with CSF signal intensity in the right superior temporal gyrus measures 23 x 20 mm, previously 25 x 20 mm, not significantly changed from prior exam. Surrounding FLAIR hyperintensity is not significantly changed. On post enhanced images the previously noted linear inhomogeneous enhancement along the posterior surgical cavity wall is not significantly changed and demonstrates restricted diffusion, intrinsic T1 shortening, and evidence of blood products. Additional focus of enhancement along the anterior inferior aspect of the surgical cavity measuring approximately 5 mm is also unchanged. 4 mm focus of enhancement along the supermedial wall of the resection cavity is also unchanged. There are no new intracranial lesions or abnormal enhancement noted. No new mass effect, herniation, or hydrocephalus.
Compared to 5/12/2015, there is no evidence of interval tumor progression. Specifically, 5 mm focus of nodular enhancement along the anterior margin of the resection cavity and 4 mm focus along the superomedial aspect of the resection cavity are not significantly changed. Additional less suspicious areas of enhancement posteriorly also remains unchanged.