Glioblastoma. Evaluate progression. There are postoperative findings of right parietal craniotomy for biopsy of a right temporal lobe mass. Compared to the prior study, there is been continued progression of multiple sites of enhancing tumor. The reference of satellite lesion anterolateral to the dominant mass measures 15 x 12 mm, previously 12 x 8 mm. Multiple additional satellite lesions has also increased in size. The dominant component of the solid and cystic mass measures 4.3 x 4.1 x 4.6 cm, previously 4.1 x 3.9 x 4.4 cm and extends into the midbrain. Intrinsic T1 signal within the dominant mass has decreased from the prior study, compatible with evolving postoperative changes. There is progressive thickening and T2 hyperintensity of the right splenium of the corpus callosum. There is also markedly increased T2 hyperintensity in the posterior left lateral periventricular white matter region. Otherwise, the extent of associated T2 hyperintensity appears similar to the prior study. There is persistent local mass effect on the midbrain and right lateral and third ventricles, with increase dilatation of the left lateral ventricle. There is diffuse local sulcal effacement and approximately 7 mm of leftward midline shift. There is no or evidence of acute infarct. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.Evidence of tumor progression, with increased size of the dominant right temporal lobe mass and increased size and number of multiple satellite lesions and slightly increased obstructive hydrocephalus.2.Continued evolution of postoperative findings related to tumor biopsy.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.