Female, 59 years old, history of GBM, baseline exam prior to starting new systemic therapy. Evidence of a left temporal craniotomy is again seen. Redemonstrated is a thickly rim enhancing lesion which occupies the anterior left temporal lobe, tracking superiorly along the lateral ventricular margin to extend into the left parietal lobe. On comparison with the prior examination, portions of the enhancing rim of this lesion show progressive thickening and the overall size is probably somewhat larger. A substantial portion of this enhancing lesion demonstrates elevated rCBV. Also redemonstrated is thin subependymal enhancement along the left ventricular atrium, temporal and occipital horns.Extensive T2 hyperintensity surrounding this lesion and occupying the entire left temporal lobe, most of the left occipital lobe and most of the left parietal lobe, is not convincingly changed in geographic extent. There remains substantial regional mass-effect with sulcal effacement, left lateral ventricular effacement and partial effacement of the left quadrigeminal plate cistern.Ill-defined bilateral periventricular T2 hyperintensity is again seen, not substantially changed and likely related to therapy. Signal abnormality is evident tracking into the posterior limbs of the internal capsules. Nonspecific patchy T2 hyperintensity is also evident within the pons.
1. Mild progressive thickening of tumor which spans the left temporal and parietal lobes.2. No significant interval change in the degree of associated edema or mass effect.