Patient History
57-year-old male who initially presented to outside hospital with facial droop and was found to have right frontal lobe mass, now presenting for preoperative imaging.
Findings
Heterogeneously enhancing mass within the right frontal operculum, measuring 2.8 x 2.9 x 2.9 cm (anteroposterior by transverse by craniocaudal).
Surrounding T2 FLAIR hyperintense signal likely reflecting a combination of nonenhancing infiltrative tumor and vasogenic edema, with minimal leftward subfalcine herniation and right uncal herniation, though without cerebellar tonsillar herniation.
DSC perfusion leakage corrected relative cerebral blood volume map demonstrates markedly increased blood volume to the mass relative to the normal brain parenchyma.
No areas of restricted diffusion (remote from the mass) to suggest acute infarct. No acute intracranial hemorrhage or extra-axial collection.
Gray-white matter differentiation is otherwise preserved. Ventricular size within normal limits for patient age. Major intracranial flow voids intact. Partially empty sella turcica.
Paranasal sinuses and mastoid air cells clear aside from mucosal polyp or retention cyst within the left maxillary sinus. Orbits normal. Scalp and calvarium unremarkable aside from frontotemporal scalp fiducial markers.
Partially visualized cervical spine appears unremarkable aside from likely an ossiculum terminale.
Impressions
Stable size and appearance of right frontal opercular mass, likely a high-grade glioma
