24-year-old female for follow-up status post right frontal/right orbital mass resection. Postoperative changes related to right frontal craniotomy and right orbitotomy are noted. There is been interval gross total resection of the intracranial portion of the large right frontal extra-axial mass. A moderate amount extra-axial fluid and a small amount of air are present over the right anterior frontal convexity and extending to the right orbit. Small area of restricted diffusion in the right inferior frontal lobe and anterior insular cortex is compatible with cytotoxic edema. There is a minimal amount of enhancement along the medial aspect of the resection cavity, favored to be related to postoperative change. No discrete nodular or masslike enhancement is present intracranially. There has been interval improvement of the mass effect on the adjacent right frontal lobe with reexpansion of the anterior horn of the right lateral ventricle. Hyperintense T2/FLAIR signal in the adjacent right frontal lobe is again seen compatible with edema and/or gliosis..The portion of the mass in the superior right orbit has at least mostly been resected. Susceptibility artifact related to the hardware implant limits assessment of residual tumor in the orbit. There are focal areas of peripheral enhancement in the superior lateral aspect of the right orbit, which may be related to postoperative changes or perhaps small amount of residual tumor and can be correlated with extent of resection. Attention on follow-up suggested. There has also been improvement of the mass effect on the right globe and improved but persistent marked right proptosis. No hydrocephalus. Major flow-voids are preserved.
1. Gross total resection of the intracranial portion of the previously demonstrated right frontal mass with minimal enhancement along the medial aspect of the resection cavity favored to represent postoperative change. No discrete nodular or masslike intracranial enhancement to definitively suggest residual intracranial tumor.2. There is at least near total resection of the superior orbital component of the tumor with susceptibility artifact limiting precise evaluation. Please see comment above.