Recurrent Glioblastoma, Right Frontal Lobe with Uncal Herniation
Findings:
Multiple MR images demonstrate postoperative changes of right temporal craniotomy. There is a large irregular peripherally enhancing cystic lesion in the right frontal lobe with significant surrounding edema and mass effect. There is also evidence of right uncal herniation with displacement of the right temporal horn into the prepontine cistern causing mass effect on the brainstem. The right lateral ventricle is moderately effaced with moderate midline shift. The left lateral ventricle is dilated suspicious for ventricular trapping.
Discussion:
Discussion of GBM is found in many other cases on this site. The case illustrates the findings of uncal herniation where the temporal horn is markedly displaced medially and abuts the brainstem. This represents a tumor recurrence.