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Axial FLAIR (Fig 1) and coronal T2 (Fig 2) images of the brain demonstrate an infiltrative hyperintense mass diffusely involving the entire brainstem, left thalamus/basal ganglia and the white matter of the entire left cerebral hemisphere. The involved structures are enlarged causing mass effect with rightward midline shift and partial effacement of the left lateral ventricle. The right internal capsule and midbrain also demonstrate subtle FLAIR and T2 hyperintensity suspicious for neoplastic infiltration as well. No enhancement is seen on the coronal post contrast T1 image (Fig 3).