A solitary vividly enhancing lesion is demonstrated on the right above the sylvian fissure in the inferior frontal gyrus. It is of heterogeneous signal, but predominantly high in T2 signal than adjacent brain, intermediate signal on T1 weighted imaging, and demonstrates a moderate degree of restricted diffusion. Prominent cerebral blood volume (CBV) is present. At the periphery of the lesion and numerous small cystic appearing regions. Beyond this extensive vasogenic type oedema extends throughout the frontal and parietal lobes, and tracks into the posterior limb of internal capsule. Unfortunately MR spectroscopy is non-contributory.
The remainder of the brain is unremarkable in appearance.
Conclusion:
Solitary right frontal lesion is difficult to characterise. The three most likely possibilities include an atypical meningioma (e.g. microcystic +/- brain invasion), a peripheral metastasis and a primary glial series tumour.