Male, 52 years old, with GBM status post resection on Ziopharm trial. Evaluate for changes in tumor. Redemonstrated is evidence of prior left temporal surgery for partial resection of a GBM. An irregularly marginated, heterogeneously enhancing lesion is again seen within the left temporal lobe spanning the temporal horn of the lateral ventricle. There has been no significant interval change in the size or geographic extent of the enhancing tissue. Lateral to the enhancing lesion and just anterior to the resection tract, there is a 24 mm intrinsically T1 hyperintense collection with strong susceptibility effect compatible with subacute blood product. This collection has increased slightly in size when compared to the prior exam.Extensive T2 hyperintensity is again seen tracking through the left temporal and occipital lobes, superiorly into the thalamus, white matter capsules and left parietal lobe. The extent and severity of this signal abnormality are stable to at most minimally increased when compared to the prior examination.The left lateral ventricle is partially effaced by edema and there is a stable slight midline shift to the right. Small cystic spaces centered on the left temporal horn, in the midst of the enhancing lesion, have slightly increased in size possibly representing tumoral cysts or loculated CSF.No definite new intracranial lesions are seen. The right lateral ventricle, third and fourth ventricles remain within normal limits. The posterior fossa structures are unremarkable.
There has been no overall increase in size or geographic extent of the irregularly marginated enhancing tissue centered on the left temporal lobe. Edema and mass effect associated with this process are stable to most minimally increased from prior. A subacute hematoma is evident within the left temporal parenchyma, just lateral to the enhancing tissue and just anterior to the surgical resection tract.