Reason: Eval for progression of GBM. Pt on TMZ. History: GBM. The patient is status was right sided ventriculostomy tube placement and ventriculostomy tube course the right frontal lobe into the right lateral ventricle across the midline with tip in the frontal horn of left lateral ventricle. There is metal artifact associated with the reservoir of the ventriculostomy tube along the scalp tissues which distorts the appearance of the right hemisphere.Another drainage tube courses to the left temporal lobe across the temporal horn of the left lateral ventricle and has its tip just anterior to the basilar artery. Is in stable positionThere is an irregularly enhancing mass present along the splenium of the corpus callosum which extends across the midline. There is greater enhancement along the right half of the splenium of the corpus callosum versus the left. Enhancement mildly surrounds the left lateral ventricle occipital horn compared or several satellite lesions are compared to the prior exam the degree of enhancement has progressed into the degree of infiltration into the right hemisphere has progressed. There is a moderate degree of periventricular and subcortical confluent hyperintense white matter lesions present identified on the FLAIR and T2 images. This has progressed since the prior exam.The visualized portions of the paranasal sinuses demonstrate minor opacities. The visualized portions of the mastoid air cells demonstrate minor opacities. The visualized portions of the orbits are intact.
1.Since the prior exam there is been interval progression of the lesion involving the splenium of the corpus callosum especially on the right side.2.Since the prior exam white matter signal changes have also progressed. These are likely treatment related.