History of epidermoid status post resection and most recently CyberKnife treatment: surveillance scan. Redemonstrated are postoperative findings related to left temporal craniotomy. There is a lobulated, non-enhancing, T2 hyperintense mass that displays restricted diffusion centered within the left choroid fissure with extension into the suprasellar cistern and third ventricle, as well as a punctate focus in the right occipital horn. The lesion appears to be unchanged in size, the main component of which measures 41 AP x 35 RL x 28 SI mm, with unchanged regional mass effect upon the brain parenchyma and left aspect of the optic apparatus. However, there is interval decrease in the T2 hyperintensity and enhancement in the adjacent brain parenchyma. There is a right transoccipital ventricular shunt catheter that terminates in the right lateral ventricle, which is unchanged. There is no evidence of acute intracranial hemorrhage or acute territorial infarct. There is no midline shift or herniation. The skull and scalp soft tissues are unchanged.
1.Stable size of the epidermoid cyst centered in the left choroid fissure with interval evolution of treatment effects in the adjacent brain parenchyma.2.The shunted ventricular system is unchanged in size, with a possible punctate fragment of epidermoid in the right occipital horn.