Reason: 63 yo male w/ gbm s/p RT/TMZ; currently on TMZ; screening for clinical trial; compare to uploaded post-resection images on 2/2/16 There has been evolution of postsurgical changes related to repeat tumor resection seen on outside MRI studies from 2/2/2016. There is evidence of left anterior temporal lobectomy with gross total resection of the enhancing mass evident in the medial temporal lobe on earlier study from 2/1/2016 as well as the nonenhancing masslike FLAIR hyperintensity in the left anterior temporal lobe. There is interval increase in enhancement along the dorsal aspect of the left anterior temporal resection cavity corresponding to the area of restricted diffusion on the immediate postoperative MRI and consistent with evolution of postsurgical change. Minimal area of somewhat nodular enhancement along the adjacent left tentorium is also increased which may also represent posttreatment change, but suggest attention on follow-up.Areas of FLAIR hyperintensity more superior to the resection cavity with minimal nonspecific enhancement along the left insular cortex is not significantly changed when compared to 1/21/2016. FLAIR hyperintensity surrounding the periventricular white matter, particularly along the left frontal horn is also nonspecific but favored to represent posttreatment change. No significant intracranial mass effect, midline shift, or herniation. No hydrocephalus.
Evolution of postsurgical changes related to repeat tumor resection involving the left anterior medial temporal lobe. There has been gross total tumor resection without evidence of interval tumor progression.