 Again seen are postoperative findings related to prior left occipital lobe GBM resection with mild interval evolution including slight decrease in size of the resection cavity. Adjacent blood products also demonstrate slight evolution. There is overall no significant change in extent of the FLAIR signal abnormality in the left occipital lobe which extends into the left periatrial region as well as the left posterior temporal lobe. Previous seen heterogeneous enhancement surrounding the resection cavity including small rounded nodules demonstrate minimal change in configuration and enhancement pattern but without clear evidence of interval progression. Small areas of increased central nonenhancement are noted. Enhancement extending to the ependymal surface of the left lateral ventricle is again seen.There is no new mass effect, midline shift, or herniation. No evidence of acute infarct or new hemorrhage. No hydrocephalus.
Compared to 4/10/2016, there is no clear evidence of interval tumor progression. Subtle differences described above may be related to radiation and evolution of postsurgical change.