Male, 64 years old, history of GBM of the temporal lobe status post resection and chemotherapy. Presenting with behavioral changes and confusion. Evidence of left anterior temporal resection is again seen. The surgical cavity is largely collapsed. Gyral thickening and T2 hyperintensity affecting the residual anterior temporal parenchyma, with extension to the left mesial temporal lobe, have not significantly changed from the prior examination. Likewise, curvilinear enhancement within the collapsed cavity shows no definite change in size or confirmation.No new intracranial lesions are seen. No evidence of new edema, mass effect, restricted diffusion or acute intracranial blood product is seen. The ventricles remain normal in size and morphology. Very mild ill-defined T2 hyperintensity within the left periatrial white matter is favored to represent a treatment related change.
Findings are redemonstrated compatible with left anterior temporal resection. Thickened T2 hyperintense anterior temporal gyri as well as thickening which extends into the mesial temporal structures may represent residual tumor but these findings are unchanged when compared to prior examination. Nonspecific enhancement within the resection cavity is unchanged as well. No new lesions are detected.