Findings: A space-occupying lesion measuring ~ 3 x 4 x 5 cm is seen in the left anterior temporal lobe. It has mixed solid & necrotic components, hemorrhagic components, and some areas of mild diffusion restriction. Solid components show moderate enhancement in the post-contrast study. Perilesional vasogenic edema, mild left-sided uncal herniation, and mild right-sided subfalcine herniation are noted. MRS shows reduced NAA and increased lactate-lipid peaks. M1 & M2 segments of the left MCA are closely adherent to the mass. Two other small faint non-enhancing focal lesions of indeterminate nature are seen in the left cerebral hemisphere (one in the left thalamus and the other in left corona radiata).
Impression: Aggressive looking left temporal lobe space-occupying lesion, suggestive of high-grade glioma; another possibility can be a metastatic lesion, which is, however, less likely.