Male, 76 years old, with GBM status post resection. Evidence of wide left temporoparietal craniotomy is seen. Extracranial soft tissue swelling and a 7 mm layer of extra-axial fluid beneath the craniotomy are expected postoperative findings.A large resection cavity is now present at the site of the previous enhancing left anterior temporal lesion containing fluid and a small amount of dependent layering blood product. At the posterior margin of the resection cavity, along the temporal horn, there is a patch of amorphous enhancement measuring 9 x 7 mm which could represent residual tumor or postoperative change. Elsewhere, only nonspecific amorphous enhancement is seen along the cavity margins.T2 hyperintensity spreading through the parenchyma surrounding the resection cavity into the occipital lobe, the operculum, the parietal lobe, the insula and thalamus appears similar to that seen on the preoperative study.Moderate generalized mass effect is seen in the left cerebral hemisphere with sulcal effacement and partial effacement of the lateral ventricle. Only minimal midline shift is seen without evidence of herniation.No evidence of acute ischemia is seen. Scattered small foci of T2 hyperintensity within the cerebral white matter may reflect chronic microvascular ischemic disease.
1. Expected findings status post resection of a large left temporal tumor.2. The previously seen tumor has been completely or near completely resected. Only a small amount of enhancing tissue is seen along the posterior margin of the resection cavity which could reflect trace residual tumor or postoperative change.