Reason: s/p tumor resection History: s/p tumor resection Prelim pathology suggestive of metastatic carcinoma. There has been interval left temporal parietal craniotomy for resection of previously seen underlying mass. Prominent susceptibility along the anterior aspect of the frontal lobes with mild mass effect as well as a few scattered foci near the convexity likely relate to pneumocephalus. There is now prominent susceptibility underlying the craniotomy flap in the surgical bed likely representing postoperative blood products as well as air. There is no significant diffusion abnormality in the area of the resection. Two punctate foci of apparent hyperintensity are seen along the cerebellar vermis (302/104) on diffusion-weighted images only, hand without correlative FLAIR abnormality or susceptibility. These may be artifactual.A tiny vessel medial to the posterior medial margin of the mass has seen on preoperative exam remains delineated. Apparent enhancement along the upper margin of the resection cavity is likely artifactual when evaluating precontrast imaging.Extent of surrounding abnormal T2/FLAIR hyperintensity extending into the adjacent left parietal lobe appears overall similar, with continued mild localized mass effect on the adjacent left ventricular atrium. There is a stable small oval area of T2/FLAIR hyperintensity in the left frontal subcortical white matter, which remains nonspecific.
Interval expected postoperative changes following gross total resection of previously seen left posterior parietal/superior temporal region mass, with residual vasogenic edema and mild localized mass effect upon the left lateral ventricle. No definite residual enhancement to suggest residual tumor, although continued follow-up is recommended.