Recurrent, disseminated glenohumeral tumor. Treated with chemotherapy and radiation treatment. Last MRI showed new contrast enhancement. Brain: There are postoperative findings related to left temporal craniotomy and tumor resection. The enhancing T2 hyperintense mass within the left middle cranial fossa surgical bed has not significantly changed. Likewise, there is unchanged is encephalomalacia surrounding the treatment bed. There is extensive enhancement within supratentorial and infratentorial sulci and basal cisterns, which has is overall similar in extent. There is no evidence of acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are unchanged. There is a right maxillary sinus retention cyst.Spine: Spine imaging is limited by patient motion. There is diffuse linear and nodular leptomeningeal enhancement in the spinal canal. There is also unchanged volume of enhancing tumor within the sacral spinal canal though the enhancement is more intense which may relate to postinjection delay. The spinal cord signal otherwise appear normal. A left paracentral disc protrusion at L5-S1 and a mild disc bulge at C3-4 are also unchanged. The spinal column alignment is unchanged. The vertebral body morphology and signal characteristics are unremarkable.
1. Unchanged residual tumor in the left middle cranial fossa and extensive leptomeningeal tumor dissemination.2. Unchanged drop metastases in the spinal canal.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.