Clinical question: Eval for growth of GBM. Pt is now on TMZ. Signs and Symptoms: GBM. Pre and post enhanced brain MRI:There is interval decreased peritumoral vasogenic edema of right hemisphere with resultant visualization of the cortical sulci and resolution of trace midline shift to the left. Surgical cavity in the high convexity right anterior parietal with thick irregular rim of enhancement also demonstrate significant interval improvement since prior exam. On sagittal postcontrast images the tumor measures approximately at 34 x 30 mm compared to prior study measurements of 37 x 41 mm.Remaining tumor demonstrate interval decreased size, significantly decreased extent of and thickness of enhancement. There are also sections of the cavity wall that demonstrate almost no enhancement. No evidence of new remote foci of flair hyperintensity or abnormal enhancement .
Interval improvement of right hemispheric GBM with overall decreased size with decreased intensity, extend and thickness of enhancement surrounding the surgical cavity. Please see above comments. 