Neurofibromatosis type I, evaluate for change in glioma and right medullary mass. Again seen is an enhancing mass involving the left prechiasmatic optic nerve just anterior to the chiasm. Mass measures approximately 16 x14 x 11 mm in the AP, transverse, and craniocaudal dimensions and not significant changed since 6/2/2015 but clearly larger when compared to remote studies. There is mass effect on the chiasm and contact with the right prechiasmatic optic nerve.Again noted is nonenhancing exophytic T2/FLAIR hyperintense mass involving the right dorsal medulla extending to the cervical medullary junction. Mass measures approximately 12 x 13 mm and remains unchanged from recent prior. Areas of T2/FLAIR hyperintensity involving the right cerebral peduncle and bilateral globi pallidi are not significantly changed from recent prior. FLAIR hyperintensity involving the bilateral cerebellar hemispheres is also not significantly changed. When compared to remote study from 2/10/2012, there is clear decrease in size and associated FLAIR hyperintensity of lesion involving the right cerebral peduncle. Lesion involving the medulla extending to the upper cervical cord is also clearly smaller when compared to remote studies. Signal abnormality involving the bilateral globi pallidi is increased compared to remote priors. Signal abnormality involving the cerebellar hemispheres is minimally decreased since 2012.No evidence of acute ischemia or hemorrhage. No new intracranial mass. No extra-axial collections. No hydrocephalus. There is mild mucosal thickening throughout the paranasal sinuses with interval improvement in opacification of the sphenoid sinuses compared to 6/2/2015.
1. Compared to 6/2/2015, there is no significant change in enhancing left optic nerve glioma. There is clear enlargement when compared to remote prior studies. 2. There is also no significant interval change in nonenhancing expansile right dorsal medullary mass compared to more recent exam, although overall decreased ventral and caudal extent compared to more remote exams.3. Redemonstration of nonenhancing areas of focal abnormal signal intensity consistent with history of neurofibromatosis which are not significantly changed since recent prior study. Please see details above.