Male, 46 years old, with GBM status post re-irradiation now on temozolomide and bevacizumab, evaluate for progression. A large resection cavity contiguous with the right lateral ventricle is again seen incorporating portions of the right frontal and parietal lobes and a small portion of the the temporal lobe. The cavity is unchanged in size and morphology.Around the periphery of the resection cavity, there is a rind of thickened, T2 hyperintense tissue which has not significant changed from the prior examination. Scattered foci of susceptibility and patchy restricted diffusion within this tissue are also unchanged. The tissue surrounding the resection cavity shows mild patchy areas of intrinsic T1 hyperintensity with superimposed ill-defined enhancement, also unchanged. No new enhancing lesions are seen. A focus of enhancement within the left IAC has been stable over many prior exams and may represent a vascular structure. Ill-defined periventricular hypoattenuation, right side more than left, is unchanged and likely represents a posttreatment effect. Tract-like T2 hyperintensity conforming to the right corticospinal tract within the brainstem is also unchanged and may represent Wallerian degeneration. No new areas of parenchymal signal abnormality are seen. Ventricular size and morphology are stable.
Stable examination with no change in the thickness or extent of mildly enhancing tissue which surrounds the large right-sided resection cavity.