GBM status post RT. Evaluate for change. Redemonstrated is a large periventricular mass with asymmetric lobular and thick rim enhancement centered at the posterior horn of the left lateral ventricle. This lesion also infiltrates the splenium of the corpus callosum, partially crossing to the contralateral side. This mass measures 5.2 x 7.2 cm (series 14, image 12) compared to 3.5 x 5.1 cm previously and has increased significantly compared to the previous exam. rCBV mapping demonstrates increased blood volume involving the thicker enhancing portions of the mass which lends further evidence of tumor progression. There is also new abnormal enhancement tracking along the ependymal region of the temporal horn of the left lateral ventricle as well as the body of the left lateral ventricle. The temporal horn of the left lateral ventricle is entrapped but unchanged compared to the previous exam. An additional focus of abnormal signal is visualized within the right middle frontal gyrus which is unchanged from prior. This may represent a additional site of discontiguous disease. There is surrounding extensive vasogenic edema which causes significant mass effect on the occipital horn of the left lateral ventricle and results in 6 mm of rightward midline shift. There is also extensive vasogenic edema in the adjacent parenchyma both ipsilaterally and to some extent contralaterally, which has increased compared to the previous exam and contributes to the midline shift. The major cerebral flow voids are intact. The orbits, skull and scalp soft tissues are grossly unremarkable. There is mild mucosal thickening of the right maxillary sinus.
Enhancing and infiltrating periventricular mass centered at the occipital horn of the left lateral ventricle with spread along the splenium of the corpus callosum to the contralateral side showing significant increase in size compared to previous exam. There is extensive surrounding parenchymal vasogenic edema which has also increased in the interim. There is also new ependymal enhancement along the left temporal horn and body of the left lateral ventricle. These findings are highly concerning for progression of disease 