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Repeat MRI a few months later demonstrates a large area of FLAIR hyperintensity involving the cortex and extending to the peritrigonal white matter. Several areas of mass like enhancement within the FLAIR hyperintensity are present. Prominently elevated CBV with prominent elevated choline and lactate with reduced NAA. Local mass effect, with distortion of the trigone
Conclusion: Findings are most in keeping with a multifocal glioblastoma.