The imaging appearances of this left temporal lobe tumor are those of a low-grade glioma, with typical features of what used to be called protoplasmic astrocytoma before the 2016 update on the WHO classification of CNS tumors, a subtype of diffuse astrocytomas that is no longer recognized as a distinct entity.

This case has been confirmed as an astrocytic tumor IDH-1 mutated and ATRX mutated, making the final diagnosis of a diffuse astrocytoma IDH-1 mutant. Remember that ATRX loss/mutation and 1p19q co-deletion are essentially mutually exclusive, which means that ATRX mutated = no 1p19q co-deletion.