Recurrent GBM with subarachnoid and subependymal dissemination

Findings:

Postoperative changes of large left frontoparietal craniotomy are incompletely included. The ventricular system is dilated with abnormal enhancement along the subependymal aspects. A large irregular enhancing mass involves the left frontal lobe extending into the basal ganglia. Superimposed subarachnoid enhancement coats the brainstem and cerebellum.

Discussion:

Recurrent malignancy with dissemination should be considered first. Superimposed meningitis is less likely.

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