Male, 34 years old, with GBM, s/p 2 cycles of Avastin, compare to 4/7/16 scan. Postoperative findings are again seen compatible with prior left frontal lobe tumor resection. The resection cavity is not significantly changed in size and the fluid in the cavity continues to progress slowly toward CSF signal on FLAIR images.Since the prior examination, soft tissue thickening inferior to the resection bed has progressed. Two previously small cystic cavities within this tissue, presumably related to prior instrumentation, have expanded. Irregular enhancement associated within this thickened tissue has also progressed. In particular, there is progressive extension of enhancement into the genu of the corpus callosum.No new areas of focal parenchymal signal abnormality or pathologic enhancement are detected elsewhere. Periventricular T2 hyperintensity, particularly around the frontal horns, has not significantly changed and is likely treatment related. The ventricles are stable in size and morphology.
Soft tissue thickening inferior to the left frontal resection cavity has progressed along with associated enhancement. There is, in addition, further extension of enhancing tissue into the genu of the corpus callosum. These findings are concerning for progressive tumor with inflammation or treatment related effect considered less likely.