24 years, Female, with an intracranial mass incompletely evaluated on orbital MRI. History of right orbital hemangiopericytoma, status post resection. The patient presented with right proptosis. There is a 5.7 x 5.4 x 6.6 cm slightly lobulated T1 hypointense and T2 hyperintense avidly enhancing extra-axial centered in the right frontal skull adjacent to the right frontal lobe. The mass causes severe compression of the right frontal lobe. There is mild underlying edema in the right frontal lobe white matter. A well-defined T2 hypointense surrounding the majority of the mass is again demonstrated with a few discontinuous areas of irregular enhancement extending beyond the margin of the capsule into the surrounding right frontal lobe parenchyma, especially inferiorly along the posterior margin. The mass extends inferiorly into the right orbit and causes severe compression of the intraorbital contents. Severe right exophthalmos and inferior displacement of the right globe are unchanged.No restricted diffusion to suggest acute infarct. No intracranial hemorrhage is evident. The ventricles are within normal limits in size and configuration. Major flow-voids are preserved.Sella and left orbit are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Postsurgical changes related to previous right frontotemporal craniotomy are redemonstrated. Bone marrow signal is otherwise within normal limits.
Redemonstrated large lobulated extra-axial mass centered in the right frontal skull most consistent with recurrent hemangiopericytoma. Unchanged findings concerning for locally invasive spread into the right frontal lobe.