Right hemispheric glioblastoma. Had open biopsy showing residual tumor and significant amounts of necrosis. Initially underwent a resection (11/18/11) and received RT/TMZ (12/11 to 01/12). There are postoperative findings related to right frontoparietal craniotomy. There is a heterogeneously enhancing mass with areas of restricted diffusion involving the right frontal lobe, insula, basal ganglia, and temporal and parietal lobes, with extension across the corpus callosum, which measures up to 10.5 cm, previously 9.5 cm. There more pronounced enhancement in the tumor and increased regional mass effect with effacement of the right lateral ventricle. The confluent T2 hyperintensity surrounding the enhancing tumor has minimally increased in extent. There is approximately 10 mm of midline shift to the left and mild right uncal and subfalcine herniation. There is no evidence of acute territorial infarction. The extracranial structures are unchanged.
Continued increase in size of the tumor involving much of the right cerebral hemisphere.