History of grade III oligodendroglioma status post resection, RT, and TMZ. There are postoperative findings related to right anterior temporal lobectomy with unchanged confluent T2 hyperintensity along the surgical margins. However, there are punctate foci of enhancement along the adjacent right hippocampal tail. There is also interval increase in size of the enhancing left cerebellar hemisphere lesions and surrounding T2 hyperintensity, measuring up to 6 mm and 15 mm each, previously 4 mm and 7 mm, respectively. There are unchanged numerous scattered supratentorial white matter T2 hyperintense lesions, which may represent chronic small vessel ischemic disease. There is also unchanged encephalomalacia in the anterior frontal lobe, as well as areas of susceptibility effect in the left frontal lobe. There is no evidence of acute infarct. The ventricles are prominent due to cerebral volume loss. The major cerebral flow voids are intact. There is a punctate left maxillary sinus retention cyst. There is minimal fluid within the bilateral mastoid air cells.
1. Postoperative findings related to right anterior temporal lobectomy with punctate foci of enhancement along the adjacent right hippocampal tail and increase in size of the enhancing left cerebellar hemisphere lesions, which may represent tumor progression and/or a second neoplasm. 2. Unchanged encephalomalacia and areas of chronic blood products in the left frontal lobe.