Adult patient with increasing headache.
MRI Brain (selected images)
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MRI demonstrates a large mass in the superior part of the right temporal lobe. It exerts significant mass effect and is surrounded by vasogenic oedema. The mass itself is heterogeneously low on T1, and demonstrates a very high T2 signal region centrally, suggestive of a necrotic centre.
Following administration of contrast, the margins enhance irregularly.
Features are most consistent with a high-grade (WHO grade IV) primary glial tumour.