Glioblastoma multiforme. On CCNU. Status post 4 cycles. There has been no significant change in size or morphology of the resection cavity incorporating the right anterior temporal lobe, a portion of the right insula, and the right inferior frontal lobe. T2/FLAIR abnormality surrounding the resection cavity is also unchanged. Associated ex vacuo enlargement of the right lateral and the third ventricles is again noted. Accounting for the increased susceptibility involving the right lentiform nucleus and the right mid brain, including the cerebral peduncle, there is no significant hyperperfusion in the treatment bed.Thin enhancement along the medial edge of the resection cavity is unchanged. The thin, nodular ependymal enhancement along the right frontal horn and minimally at the right atrium shows no significant or convincing interval change. A small ill-defined area of enhancement along the anterior body of the left lateral ventricle (1301/118) is slightly more conspicuous and more solidly contrast enhancing especially when compared to more remote exams, with suggestion of mild, focal elevation of the cerebral blood volume on the color-coded map. Otherwise, these foci of contrast enhancement are too small to accurately resolve by perfusion.Otherwise, there is no new enhancing or T2 hyperintense lesions are seen. Mild periventricular T2 hyperintensity along the left lateral ventricle is unchanged and probably related to treatment. Ventricular size and morphology are stable.The major intracranial arterial flow voids are preserved otherwise. There are small retention cysts in the maxillary sinuses. Chronic fluid signal in the right mastoid air cells is still present.
1.No convincing disease progression around the resection cavity. 2.The nodular ependymal contrast enhancement along the left lateral ventricular anterior body along the corpus callosum has gradually slightly increased in conspicuity and confluence of enhancement as described above. Close attention on follow-up examination is recommended. The other foci of ependymal contrast enhancement on the right remain unchanged. 