Male, 70 years old, with pineal parenchymal tumor. Postoperative findings are redemonstrated compatible with biopsy/partial resection of a bulky enhancing pineal tumor utilizing a posterior right paramedian occipital approach. Since the prior examination, the acute postoperative findings have resolved. The previously seen excavated tract within the tumor core has either collapsed or, more likely, filled via tumor ingrowth. The lesion is overall larger than on the prior examination, measuring up to 36 mm in the transaxial plane, previously 31 mm. As on prior examinations, the tumor appears to infiltrate the adjacent thalami with ill-defined T2 hyperintensity tapering laterally, particularly on the right.A right frontal approach ventricular catheter remains in stable position. Ventricular caliber has increased, more so on the right where the atrium now measures up to 18 mm in diameter, previously 11 mm. Extensive patchy white matter T2 hyperintensity is grossly unchanged. No new lesions are detected.
Since the prior examination, the surgical tract into the core of the pineal tumor has filled in likely through tumor regrowth. The overall size of the lesion has also increased mildly.