Right frontal large infiltrative space-occupying lesion is seen spreading along the genu and body of the corpus callosum reaching the contralateral left frontal lobe and also spreading along the right corticospinal tract. The lesion elicits isointense signal on T1 WI and heterogeneous high signal on T2 WI showing small necrotic cystic areas at the genu of the corpus callosum and at the right deep frontal region. The lesion shows patches of diffusion restriction mainly seen the genu of the corpus callosum, corticospinal tract and the high frontal region.
Linear track of cystic and hemorrhagic signal, and patchy contrast enhancement is seen at the right anterior frontal region, representing sequel of stereotactic intervention.
The lesion is surrounded by vasogenic oedema and exerting positive mass effect.
Based on the radiological features of the lesion especially the extension of the lesion along the corticospinal tract and corpus callosum, as well as the aggressive features including necrotic cystic areas and patchy contrast enhancement, high-grade glioma was considered most likely with gliomatosis growth pattern.