Low grade astrocytoma. There are postoperative findings related to biopsy of a heterogenously enhancing stellate-shaped mass in centered in the left peritrigonal white matter extending to left pre and postcentral gyri and left thalamus that measures up to approximately 4 cm. The mass also contains areas of susceptibility effect that correspond to calcifications and is surrounded by confluent areas of high T2 signal. Some portions of the mass appear to have gradually increased in size. Furthermore, there is now a small patchy area of enhancement in the right paracentral lobule with surrounding high T2 signal, as well as a punctate focus of enhancement in the left splenium of the corpus callosum in an area of increased high T2 signal and swelling. There are otherwise unchanged T2 hyperintense lesion in the periventricular and subcortical white matter and in the brainstem, which are nonspecific. There is no evidence of acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Findings suggestive of gradual progression of the mass centered in the left peritrigonal white matter extending to left pre and postcentral gyri and left thalamus , as well as development of what appears to be additional enhancing tumor in the left paracentral lobule and splenium of the corpus callosum. 