Anaplastic astrocytoma status post chemotherapy and radiation treatment. Headache and weakness. Right parietal temporal craniotomy changes are again seen. There has been interval progression of right parietotemporal lobe enhancing infiltrative tumor with new extension into the right frontal lobe surrounding the anterior horn of the right lateral ventricle with extension superiorly along the midline vertex. There is increased infiltrative tumor extending along the genu, body, and splenium of corpus callosum. New foci of enhancement are demonstrated in the left centrum semiovale. There is overall increased mass effect and effacement of the right lateral ventricle. T2 signal extending inferiorly along the right cerebral peduncle also appears increased since prior examination. A focus of susceptibility along the right precentral gyrus likely represents a biopsy marker. Hemosiderin deposition the surgical bed is similar to prior examination.
Interval unfavorable changes with significant progression of tumor involvement within the right frontal lobe, corpus callosum, with extension into the left cerebral hemisphere.