Centred in the deep white matter of the posterior temporoparietal region on the left there is a 3 cm heterogeneous peripherally enhancing mass which abuts the ventricles and appears to have a degree of subependymal spread.
Nodular restricted diffusion is demonstrated around the margins of the lesion corresponding to the enhancing component, with no central restricted diffusion.
The mass has surrounded by a large amount of oedema which results in local positive mass effect, but no midline shift.
MR spectroscopy predominantly demonstrates elevated lactate but probably also has some elevation of choline and reduction in NAA, although the trace is sub optimal.
MR perfusion demonstrates elevation of cerebral blood volume (CBV) in the enhancing component and reduction within the oedema.
A single small focus of T2 hyper intensity in the superior gyrus of the right frontal lobe is located the grey white matter junctions.
This only measures are few millimetres in size, it is not have any associated enhancement and is of uncertain significance. The remainder of the brain is unremarkable with no intra or extra-axial abnormality.
Left sided lesion most likely represents a high grade glioma (GBM, WHO grade 4).
The differential is of a metastasis although this is felt less likely.
Imaging features are not those of an abscess.