Atypical meningioma: surveillance. There are interval postoperative findings related to posterior parietal cranioplasty for resection of recurrent meningioma. There is interval increase in size of the heterogeneously enhancing mass in the resection cavity that measures up to approximately 70 mm overall, previously approximately 50 mm. There is extensive vasogenic edema in the surrounding brain parenchyma. There is persistent prominent leptomeningeal enhancement, with increase in size and number of small nodular enhancing foci in the left precuneus. There is also sulcal prominent susceptibility effect in the right frontal and left parietal lobes, which may represent chronic hemorrhage or cortical vein thrombosis. There are unchanged scattered foci of nonspecific cerebral white matter T2 hyperintensity in the anterior frontal lobes. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There are bilateral lens implants. There are persistent secretions in the left frontal sinus.
Postoperative findings related to parietal convexity meningioma resection with interval increase in size of the tumor and extensive vasogenic edema in the surrounding brain parenchyma, as well as what appears to be regional leptomeningeal tumor spread.