Female, 58 years old, with GBM, status post tumor resection. Since the prior examination, a large right parietotemporal craniotomy has been performed with mesh cranioplasty. Postoperative findings are seen compatible with resection of a recently progressive enhancing lesion in the right anterior temporal lobe. The resection cavity is fluid and debris-filled with susceptibility effect along the cavity margins. Scattered areas of diffusion restriction around the cavity margins likely reflect postoperative cytotoxic edema. Postcontrast images are degraded by motion artifact and are further complicated by the presence of intrinsically T1 hyperintense tissue/fluid in the operative region. As such, it is difficult to accurately assess the degree of residual enhancing tissue. Some residual tissue is likely present posteriorly and medially, but it does appear that the majority of the previously quite extensive enhancement has been resected.A pre-existing resection cavity more posteriorly within the right temporal lobe does not appear to have changed significantly. Extensive T2 hyperintensity spreading through the right cerebral hemisphere is redemonstrated appearing similar to the preoperative study. There is partial effacement the right lateral ventricle and perhaps a septation in the right occipital horn. Mild periventricular T2 hyperintensity on the left is unchanged. A focus of diffusion restriction within the right splenium of the corpus callosum is unchanged. No new enhancing lesions are seen within the limitations of this examination. The right mastoid air cells are newly opacified.
Postoperative findings are seen compatible with resection of the recently progressive enhancing lesion in the right anterior temporal lobe. It appears that a majority of the enhancing lesion has been removed, though some residual enhancement is suspected posteriorly and medially.No new lesions are seen. Extensive T2 signal abnormality spreading through the right cerebral hemisphere with associated mass effect is unchanged.