Reason: history of optic gliomas s/p chemotherapy, surveillance exam History: history of optic gliomas s/p chemotherapy, surveillance exam There is interval worsening of the left enhancing lesions along the optic pathway. For reference, enhancing component just posterior to the left optic chiasm measures 1.2-cm (series 1401 image 15), previously 0.5-cm. More posteriorly located left enhancing lesion also appears more convex and rounded. There is interval improvement of the right enhancing lesions along the optic pathway. For reference, enhancing lesion adjacent to the basal ganglia and measures 0.7 x 0.7 cm (series 1401 image 14), previously 0.9 x 0.9 cm.There is new right hypothalamic punctate lesion with new mild mass effect on the inferior third ventricle.Intraorbital component of the optic nerve gliomas, right larger than left, appear to stable with persistent mild enhancement of the orbital segment of the right optic nerve and marked dilatation of the right optic nerve sheath. There is persistent faint intrinsic T1 hyperintensity of the bilateral basal ganglia and dentate nuclei, which may be metabolic in etiology. There is no evidence of acute infarct. The ventricles are mildly prominent, which is unchanged. There is no midline shift. Moderate amount of fluid is noted in the left mastoid air cells, new from prior study. Mucosal thickening of right maxillary and left ethmoid sinuses.
1.Interval worsening of the left enhancing lesions along the optic pathway.2.Interval improvement of the right enhancing lesions along the optic pathway. 3.New right hypothalamic punctate lesion with mild mass effect on the third ventricle, likely representing additional tumor.4.Stable appearing intraorbital component of the optic nerve gliomas.5.Moderate amount of fluid in the left mastoid air cells. Please correlate clinically.