Clinical question: Baseline scan prior to starting system the chemotherapeutic treatment. Compared with prior exam and 3 -- 23 -- 15 Pre-and post-enhanced brain MRI: Negative diffusion weighted images.Examination demonstrates significant interval increased size off an enhancing mass involving the splenium of corpus callosum (right greater than left). The largest central and rightward component of the mass measures at 25 x 44-mm compared to prior study measurement of 15 x 32.Component of the tumor immediately to the left of the midline in the splenium of corpus callosum also demonstrate significant change in size. On current exam it measures approximately at 17 x 17.5-mm compared to prior study measurements of 13 x 7.5 mm.Previously noted extension of tumor into the left occipital lobe also demonstrate interval increased size and extent. The tumor extends into the trigone of left lateral ventricle and extends along the ependymal lining of the trigone and the occipital horn of the left lateral ventricle.Multiple previously noted small satellite lesions in the left splenium of corpus callosum also demonstrate interval increased size and with central necrosis as was noted on prior study. Mildly dilated supratentorial ventricular system and ventricular catheters demonstrate no change.There is a developmental venous anomaly in the right frontal lobe similar to prior exam.Diffuse flair hyperintensity of bilateral hemispheric white matter representing peritumoral edema as well as posttreatment changes with interval progression.
1.Interval progression of an enhancing mass involving the splenium of the corpus callosum ( R > L), left occipital lobe, left trigone and occipital horn of left lateral ventricle as detailed/measured above.2.Stable ventricular size and right frontal approach ventricular catheter.3.Extensive flair hyperintensity of bilateral hemispheric white matter (right greater than left) consistent with peritumoral edema and posttreatment changes also demonstrate progression since prior study.