GBM, status post RT/TMZ, now 2 cycles of TMZ. Again seen are postsurgical changes of right temporoparietal craniotomy for partial tumor resection involving the right temporal lobe. Compared to most recent outside MRI from 7/24/2015, there is decrease in T2/FLAIR hyperintensity surrounding the resection cavity, particularly involving the right inferior frontal and superior temporal lobes. There is significant decrease in associated mass effect with reexpansion of the right lateral ventricle and resolution of previously seen leftward midline shift. There is also significant interval decrease in enhancement surrounding the resection cavity with area of nodular enhancement previously measuring approximately 15 mm in thickness now measuring 8 mm in thickness. Again noted is enhancement extending along the right periatrial white matter towards the splenium, also improved in the interval. Separate focus of enhancement involving the right temporal lobe cortex more anterolaterally previously measuring 15 mm in the AP dimension now measures 13 mm. There is mild increase in FLAIR hyperintensity along the bilateral frontal horns and adjacent to the body of the lateral ventricles likely reflective of posttreatment change. Thicker T2/FLAIR hyperintensity surrounding the left occipital horn is not significantly changed in the interval.
1. Posttreatment changes related to right temporal GBM. Compared to most recent outside MRI from 7/24/2015, there is significant decrease in FLAIR hyperintensity and enhancement surrounding the right temporal resection cavity likely related to Avastin therapy.2. Improvement in mass effect and resolution of midline shift.3. Slight decrease in size of enhancing right lateral temporal lobe satellite lesion.