69 years Male (DOB:7/7/1946)Reason: grade II astrocytoma on TMZ. History: grade 2 astrocytoma.PROVIDER/ATTENDING NAME: RIMAS V. LUKAS RIMAS V. LUKAS There is a mass involving right basal ganglia, thalamus, insular cortex and adjacent right frontal lobe which extends to involve gray and white matter of the insular cortex and right orbital gyrus and right inferior frontal gyrus as well as the anterior aspect of the right temporal lobe. It does not display any contrast enhancement. On the current exam there is new T2 signal hyperintensity which extends further superiorly into the right frontal lobe white matter. This is a new T2 signal hyperintensity is higher signal than the rest of the lesion. There is an associated cystic component measuring 12 x 17 mm in size within this tumor which on the March exam measured 8 x 6 mm axial dimensions.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate a mucous retention cyst in the right maxillary sinus and mucosal thickening elsewhere in the paranasal sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
There is a mass involving right frontal lobe, anterior temporal lobe, insular cortex, right thalamus and basal ganglia. Since the prior exam a new area of T2 signal hyperintensity has developed in the right frontal lobe subcortical white matter adjacent and superior to the previously seen lesion. It is possible this represents vasogenic edema with or without tumor infiltration. There is also a new cystic component within the tumor which has enlarged compared to the previous exam.