 There are post-surgical changes related to a right parieto-occipital craniotomy for prior tumor resection with minimal enhancement along the resection cavity margin. There is interval enlargement of an enhancing mass in the right occipital lobe lateral and inferior to the postoperative cavity, which currently measures 21 x 25 mm, previously 12 x 12 mm.There is associated mild restricted diffusion and increased relative cerebral blood volume on perfusion imaging. There is interval increase in the degree of abnormal T2 signal surrounding the resection cavity. A few scattered foci of T2 hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific. There is no new enhancing mass or mass effect. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. A small lipoma is again partially visualized in the left posterior neck soft tissues.
1. Compared to 2/12/2015, there is enlargement of the right lateral occipital enhancing mass inferolateral to the resection cavity highly suspicious for tumor progression. There is also mild interval increase in surrounding FLAIR hyperintensity.2. Right medial occipital resection cavity demonstrates mild areas of peripheral enhancement along its margin similar to prior, which may represent treatment related change.