Female, 38 years old, receiving radiotherapy for craniopharyngioma, evaluate cystic lesions. A predominantly cystic, rim-enhancing lesion is redemonstrated centered on the suprasellar cistern and third ventricle. The inferior aspect of the lesion has not significantly changed in size. However, that portion of the lesion which extends through the left foramen of Monro to enter the left frontal horn has increased. There is, as a result, a greater degree of left lateral ventricular dilatation with transependymal CSF flow. A midline shift to the right of up to 14 mm is seen with subfalcine herniation. Evidence of left frontal approach biopsy is seen. There appears to be a small amount of brain parenchyma which herniates into the burr hole defect.
Continued expansion in size of the cystic suprasellar and third ventricular region lesion. In particular, that portion of the lesion which herniates through the left foramen of Monro to invade the left lateral ventricle has increased in size. Left lateral ventricular dilatation has also increased from prior. There is generalized mass effect in the form of midline shift and subfalcine herniation.