Optic nerve gliomas, 24 months off chemotherapy Orbits: There is no significant interval change in the peripherally-enhancing right orbital segment optic nerve glioma with a central cystic component, which measures up to 7 mm in diameter. The other orbital contents are otherwise unremarkable. Brain: T2/FLAIR hyperintense cystic lesion along the right optic tract extending inferiorly into the right medial temporal lobe measures approximately 12 x 12 x 13 mm previously approximately 9 x 9 x 7 mm. There is also interval development of peripheral enhancement. Findings suspicious for progression.There is no significant interval change in the non-enhancing T2 hyperintense lesion centered within the left optic chiasm and hypothalamus that measures approximately 10 x 14 mm. T2/FLAIR hyperintensity along the lateral aspects of the thalami is not significantly changed. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The skull and scalp soft tissues are unremarkable. There is mild scattered paranasal sinus mucosal thickening.
Compared to 10/9/2015, there has been interval development of enhancement as well as mild increase in size of lesion along the right optic tract which extends into the right medial temporal lobe, findings consistent with glioma progression. Remainder of the bilateral optic pathway gliomas are unchanged.