Evaluate for growth of GBM. S/P RT and TMZ. Patient on TMZ. Again seen are postsurgical changes of left frontal craniotomy for tumor resection with chronic blood products along the surgical tract extending to the basal ganglia. Compared to 4/9/2015, there is mild increase in T2/FLAIR hyperintensity in the right frontal periventricular white matter and no significant change in the FLAIR hyperintensity surrounding the resection cavity, left frontoparietal corona radiata, and left temporal stem. There is mild decrease in FLAIR hyperintensity involving the right superior frontal gyrus associated with the enhancing lesion. Right superior frontal gyrus enhancing lesion measures approximately 4 mm and is slightly smaller than before and more noticeably smaller when compared to remote priors. Focus of enhancement involving the left middle frontal gyrus adjacent to the resection cavity also continues to decrease in size.No new mass or suspicious enhancement is appreciated. No evidence of intracranial mass effect, midline shift, or herniation. No hydrocephalus. Left maxillary mucus retention cyst.
No evidence of tumor progression. There is continued decrease in foci of enhancement in the left and right frontal lobes. FLAIR hyperintensity involving the left greater than right cerebral white matter is compatible with posttreatment change.