Patient came for a follow up study after not opting for surgery, reluctant to take any intravenous contrast
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A 3.1 x 6.5 x 6.0 cm (TR x AP x CC) extra-axial solid dural-based lesion is seen along left temporofrontal convexity causing moderate vasogenic edema in perisylvian cortex. No cortical infiltration. Lesion is isointense to grey matter in all pulse sequences with diffusion restriction. Areas of blooming on gradient imaging, likely calcification. Hyperostosis of underlying calvaria. 5 mm midline shift to right. Ipsilateral lateral ventricle mild compression. Normal rest of supratentorial neuroparenchyma. No transtentorial herniation. MRS reveals significant rise in choline with an elevated lactate peak. Reduced NAA.