Male, 59 years old, history of GBM, assess for growth. Has been on Avastin and AMG386 since 1/2015. Findings are redemonstrated compatible with prior left temporal surgery. A heterogeneous, hemosiderin stained lesion occupying a large part of the left lateral temporal lobe has increased in size, including the thick enhancing component, particularly when compared to examinations from early 2015 and before.Numerous additional areas of tumor have also progressed, including an enhancing lesion within the right frontal lobe, as well as scattered nodular diffusion-restricting deposits along the corpus callosum and bilateral centrum semiovale bilaterally, some of which are new and some of which are larger. Diffuse nonenhancing T2 hyperintense thickening through the right temporal lobe is not substantially increased. Likewise, T2 hyperintense signal within the bilateral thalami is grossly stable. Vague bilateral periventricular T2 hyperintensity, distinct from the nodular disease mentioned above, has not significantly changed and is likely treatment related.No new or significant generalized mass effect is seen. No new abnormal collections are detected. Ventricular system is stable in size.
Progressive multifocal tumor with a combination of growing and new lesions.