What is the differential diagnosis for this appearance?
Show Answer
For these multiple ring-enhancing lesion consideration include cerebral abscess and primary or secondary brain tumour.
Multiple peripherally enhancing lesions with central hypodensity in the right frontal lobe. Significant surrounding vasogenic oedema. There is effacement of the frontal horn of the right lateral ventricle, subfalcine herniation and right-to-left midline shift of 13mm at the level of the septum pellucidum. No tonsillar or uncal herniation. The left ventricle is not dilated
No other areas of abnormal contrast enhancement. Mastoid air cells and paranasal sinuses are clear.
Conclusion:
Multiple peripherally enhancing lesions in the right frontal lobe resulting in significant mass effect. In the setting of fever, the findings are suspicious for cerebral abscesses. The differential includes metastatic lesions and a primary brain tumour. MRI is recommended to further evaluate.
