Female, 8 months old, with history of progressive astrocytoma status post craniotomy and chemotherapy. Evaluate disease status. The lobular suprasellar mass shows minimal if any interval increase in size. For example, in the sagittal plane, the lesion measures up to 59 mm, previously 57 mm when measured similarly, a difference which could be accounted for by technique. The lesion itself remains predominately solidly enhancing with areas of central necrosis and some cystic components which project into the left middle cranial fossa. It is possible that these cystic components have increased slightly in size as well.Mass effect on the adjacent frontal and temporal lobes is approximately similar to prior. The bilateral ICAs and proximal circle of Willis vessels are encased by the tumor. Encephalomalacia in the right frontal lobe is unchanged. Slight prominence of the lateral and third ventricles is unchanged as well.
While it is possible that the large optic pathway/hypothalamic astrocytoma has increased slightly in size, the difference relative to the prior examination is on the order of 1 or 2 mm and may not be entirely reliable. Morphologically, no significant changes are seen.