Left temporoparietal giant space-occupying lesion measuring about 10.0 x 9.3 x 7.2 cm at its maximum TS, AP & CC dimensions. The lesion elicits a marginal low signal on T2 WI with a large necrotic center. It shows small areas of blooming effect on SWI likely secondary to paramagnetic material or microhemorrhagic foci. It also shows heterogeneous marginal post-contrast enhancement. The lesion is surrounded by large perifocal edema which together with the lesion exert a positive mass effect in the form of compression of the left lateral ventricle and protrudes extra-cranially through the left temporal craniectomy defect.
The left cerebral extra-axial space, the suprasellar and quadrigeminal cisterns show multiloculations likely secondary to adhesions sequel of prior surgical intervention.
MRS showed elevated Choline peak and Cho/Cr ratio. Reduced NAA peak and markedly elevated lipid/lactate peaks.