Anaplastic astrocytoma, WHO grade III, treated with TMZ and radiation therapy. There are post-treatment findings unchanged cystic cavities in the left parietal lobe. However, there is interval increase in size and number of the enhancing lesions with susceptibility effect in the treatment bed region. For example, an enhancing lesion in the left periatrial white matter measures 10 x 18 mm, previously 8 x 14 mm. There appears to be increased blood volume associated with at least some of the lesions, although a few are too small to characterize on perfusion imaging. There is persistent surrounding confluent white matter T2 hyperintensity. There is an unchanged lesion with susceptibility effect and central T1 hyperintensity in the inferior pons, with an associated developmental venous anomaly, but no surrounding T2 hyperintensity. There is diffuse surrounding confluent T2 hyperintensity in the white matter, without associated mass effect. There is no midline shift or herniation. The orbits are unremarkable. There are bilateral maxillary sinus retention cysts.
1. Post-treatment findings in the left parietal region with interval increase in size and number of lesions in the treatment bed region, which may represent tumor progression.2. Subcentimeter pontine cavernous malformation with associated developmental venous anomaly, but no evidence of surrounding edema.