Female, 24 years old, with sarcoma status post resection x2. Postoperative changes are again seen compatible with resection of a large right frontal intracranial and orbital tumor. An epidural collection along the craniotomy has become smaller. Encephalomalacia of the right frontal lobe appears relatively similar to the prior exam. Intracranially, there are scattered nonspecific foci of enhancement along the dura as well as epidural thickening and enhancement along the craniotomy favored to be postoperative in nature.Proptosis of the right globe has improved. A fluid collection previously seen within the superior right orbit has resolved. An enhancing nodule is present within the superior right orbital apex which measures approximately 18 x 12 x 12 mm. It is difficult to discern if this lesion was present on the prior examination. Scattered smaller nodules are also seen along the superior orbit including along the lateral and medial margins (see images 71 through 74, series 1002).Elsewhere no new intracranial or orbital enhancing lesions are seen. Scattered foci of cerebral white matter T2 hyperintensity are nonspecific. Apart from mild ex vacuo dilatation of the right frontal horn, the ventricular system remains within normal limits.
Expected evolution of postoperative findings are seen compatible with resection of a prior large tumor involving both the right orbit and intracranial space. No definite residual or recurrent intracranial tumor is seen. However, a soft tissue nodule within the superior aspect of the right orbital apex is concerning for tumor. It is difficult to determine whether this lesion was present on the prior examination. Smaller nodules within the superior orbit are nonspecific but could also potentially represent tumor.