Clinical question: Status post tumor resection. Signs and symptoms: Status post tumor resection. Pre and post enhanced brain MRI:Examination demonstrates postoperative changes of left posterior temporal craniotomy for removal of tumor. Extensive residual peritumoral vasogenic edema and its associated mass effect with resultant effacement of left occipital horn and trace deviation of midline to the right is again noted.A surgical cavity containing a small amount of hemorrhage and procedural air is noted. Surgical cavity measures approximately 26 x 28 mm in transaxial dimensions. Post enhanced images there is a thick irregular wall enhancement of surgical cavity primarily along its inferior medial aspect which is highly suggestive of residual tumor. This component of tumor is abutting the occipital horn of left lateral ventricle and measures at least at 26 mm in length and 13 mm in transverse axis. On sagittal post enhanced series 14 image 24 residual mass appears larger and measures at 30 x 33 mm in size.There is a visualization of a stable enhancing mass in the posterior lateral aspect of right cerebellum since prior study measuring at approximately 18 x 12 mm in size.
1.Expected postoperative changes of left posterior temporal-parietal craniotomy as detailed.2.There is residual enhancing tumor abutting and encasing the left occipital horn of lateral ventricle measuring at 30 x 33 millimeters on sagittal post enhanced images.3.Stable diffuse peritumoral edema and associated mass effect with trace deviation of midline to the right.4.Stable enhancing right cerebellar tumor since prior exam as detailed/measured above.