Male, 63 years old, history of progressive glioblastoma, follow-up examination. A resection cavity is redemonstrated involving the right anterior temporal lobe, a portion of the right insula and frontal operculum, and a portion of the right inferior frontal lobe. The size and morphology of the resection cavity are unchanged.Enhancement along the ependyma of the right frontal lobe appears slightly more prominent than on the immediate prior examination of 7/10/2015. This remains improved, however, when compared to the examination of 4/17/2015.Enhancement along the medial aspect of the resection cavity, which is contiguous with the ependymal enhancement discussed above, has not significantly changed. Enhancement along the septum pellucidum is also not significantly changed compared to the immediate prior study, but is improved relative to the 4/17/2015 exam.A small region of enhancement along the ependyma of the right lateral ventricular body appears slightly longer than on the prior examination, now measuring up to 9 mm in length, previously 7 mm. A second small area of ependymal enhancement along the right ventricular atrium is unchanged.Curvilinear enhancement at the superior lateral margin of the right ambient cistern has progressively diminished in size, particularly when compared to 4/17/2015. No entirely new areas of pathologic enhancement are detected.The degree of T2 signal abnormality surrounding the resection cavity and extending into the right frontal white matter has not significantly changed. Mild periventricular T2 hyperintensity along the left frontal horn is also unchanged as are a few additional scattered small foci of white matter T2 hyperintensity. The ventricular system is stable in size and morphology.
Redemonstrated are findings related to tumor resection and treatment. No large or significant interval changes are seen, though there are some mild interval changes of uncertain clinical significance. For example, ependymal enhancement along the frontal horn and body of the right lateral ventricle may be slightly more prominent than on the prior examination. However, in other areas, enhancement has progressively decreased. These fluctuating imaging findings are difficult to interpret as they could reflect fluctuations in disease status, treatment related findings, or even technical differences between scans.