Female 39 years old Reason: s/p crani History: eval for tumor.Additional history: Patient has undergone two resections of a left CP choroid plexus papilloma in 2009 and in 2011 via left suboccipital craniotomies. A third craniotomy and resection of residual tumor was performed 11/1/2016. Subsequently residual tumor is again seen and another resection was performed 11/7/2016. Postoperative findings related to recent left suboccipital craniectomy for resection of recurrent choroid plexus papilloma in the left posterior cranial fossa and cerebellopontine angle. Expected postoperative findings include scattered pneumocephalus and air-fluid levels in the resection cavity. The majority of the medial and lateral enhancing tissue in the cerebellopontine angle has been resected. There is thin enhancing tissue around the resection cavity, favored to be postsurgical. A more nodular focus located posteromedially in the resection cavity measures approximately 6 x 6 mm (series 13, image 10), which is non-specific. Again seen is extensive encephalomalacia in the left cerebellar hemisphere and middle left cerebellar peduncle. There is no evidence of acute intracranial hemorrhage or acute infarct. The lateral and third ventricles, as well as the basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Postsurgical changes related to recent left suboccipital craniectomy and resection of recurrent tumor in the left posterior cranial fossa and cerebellopontine angle. A majority of the abnormal enhancing tissue has been resected. A small amount of peripheral thin linear enhancement around the resection cavity is favored to be postsurgical in etiology. A more nodular focus of enhancement is non-specific. Attention to this area is suggested on follow-up studies.