Female, 68 years old, with history of left temporal high-grade astrocytoma, postoperative MRI for radiation planning. An infiltrative T2 hyperintense mass is redemonstrated centered primarily on the left temporal lobe with extension into the occipital lobe, the left aspect of the splenium of the corpus callosum and superiorly into the parietal white matter. The lesion has increased in size from the prior examination, now measuring 94 mm in maximal dimension and 43 mm in width, previously 88 mm x 30 mm.On postcontrast images, the lesion again demonstrates vague cloudlike enhancement with a few superimposed nodular areas of enhancement. In general, the enhancement is less intense than on the prior examination which could be related to technique. However, it appears that some subtle cystic degeneration has occurred within the core of the lesion. The lesion also shows progressive internal susceptibility which may reflect petechial hemorrhage.The lesion induces mass effect in the form of atrial and temporal horn and sulcal effacement which is somewhat progressed from prior. No evidence of frank brain herniation is seen. Sequelae of stereotactic lesional biopsy are demonstrated.Elsewhere intracranially, a few scattered nonspecific foci of T2 hyperintensity are redemonstrated in the cerebral white matter. No convincing evidence of tumor is seen in the right cerebral hemisphere.
Interval increase in size of a large infiltrative tumor centered on the left temporal lobe.