11-year-old male with glioblastoma multiforme status post recent cycle 10 temozolomide as well as radiation therapy completed, which 11/14/2014, now off therapy. There are postoperative findings related to right transfrontal biopsy of the brainstem. There is persistent and unchanged increased T2 signal in the right aspect of the posterior pons and midbrain, as well as in the medial thalamus. There are punctate foci of intrinsic T1 hyperintensity within the brainstem, which are unchanged. However, there is a newly apparent punctate focus of possible enhancement in the left paramedial pons adjacent to an intrinsically T1 hyperintense focus. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits and paranasal soft tissues are unremarkable.
A newly apparent punctate focus of possible enhancement in the left paramedial pons adjacent to an intrinsically T1 hyperintense focus is nonspecific and too small to arcuately characterize. Nevertheless, close interval follow up may be useful in case this actually represents incipient tumor progression.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.