Male, 17 years old, with history of pineal region tumor, status post chemotherapy and radiation, 4 weeks post radiation scan. Irregular enhancement in the pineal region is again seen measuring approximately 10 x 10 mm (image 14 series 1001), not significantly changed from the prior examination accounting for technical differences between scans.No new areas of pathologic parenchymal enhancement or signal abnormality are seen. Evidence of a prior right frontal approach biopsy tract is redemonstrated similar to prior. Patchy T2 hyperintensity within the bilateral parietal periventricular white matter is stable from prior, perhaps representing white matter thinning or prominent perivascular spaces in association with previous transependymal CSF flow. Ventricular caliber and morphology remain within normal limits and are significantly improved from earlier exams. No acute intracranial hemorrhage or any abnormal extra-axial fluid collection is seen.
Stable irregular enhancing lesion in the pineal region compatible with a treated germinoma. As noted on prior exams, this lesion is much improved when compared to older studies. No new intracranial lesions are seen.