Grade 2 astrocytoma, status post radiotherapy, currently on TMZ. Postoperative changes are again seen from previous left frontal approach biopsy, with T2 hyperintensity along the biopsy tract. Previously biopsied left thalamic lesion overall measures 2.3 x 3.8 cm in greatest axial dimensions, previously 2.4 x 3.8 cm without significant interval change from most recent prior exam. There is no associated enhancement. There is continued mass effect upon the third ventricle, unchanged. There is slight persistent T2 signal abnormality in the left amygdala and mesial temporal lobe, but on comparison with previous exam from 11/4/2014, improved. There may be mild curvilinear enhancement in the tail of left hippocampus, which is decreased from prior. There is interval progression of patchy T2 hyperintense/FLAIR signal mostly along the left periventricular frontal lobe, likely related to posttreatment effect.The ventricles and cortical sulci are mildly prominent, unchanged. There are a few scattered and confluent cerebral white matter T2 hyperintense foci are nonspecific and similar to prior. There may be trace midline shift to the right, unchanged. The major cerebral flow voids are intact. There is mild mucosal thickening in the maxillary sinuses.
Stable left thalamic and mesial temporal lobe lesion. No significant interval change in size or signal abnormality compared to the prior exam. Mild interval progression of T2 FLAIR signal along the left periventricular frontal lobe, related to posttreatment effect.