Clinical question: Postop tumor resection. Evaluate of resection of the one out of two tumors. Signs and symptoms: Postop craniotomy. Pre and post enhanced brain MRI:Examination demonstrates expected postoperative changes of a large right temporal and frontal craniotomy for tumor debulking. There is partial resection of a large necrotic tumor in the right temporal lobe. The surgical cavity demonstrates small amount of hemorrhage and expected postoperative air. Postcontrast images demonstrate extensive residual thick irregular rim enhancing tumor. The remaining tumor and postoperative changes measures approximately 28 x 38 mm in transaxial dimensions. Fairly extensive surrounding vasogenic edema demonstrate no significant change.A second necrotic rim-enhancing tumor in the right frontal operculum measuring approximately at 25 x 29 mm in transaxial dimensions. The constellation of postop, residual tumor and right frontal mass results in leftward deviation of midline of approximately 8 mm which has not significantly changed since prior study. There is no evidence of ventriculomegaly.Findings suggestive of mild chronic small vessel ischemic strokes without significant change.
1.Postoperative changes of debulking/partial removal of right temporal lobe tumor with extensive residual tumor as detailed.2.Stable large necrotic ring-enhancing tumor in the right frontal operculum since prior exam.3.Constellation of above findings and extensive residual vasogenic edema results in approximately 8 mm leftward midline shift as detailed.