Large left frontal extra axial lesion measuring 3.8 x 6.9 x 7.3 cm in diameter is again demonstrated, with broad dural contact as well as intimate association with the falx. The lesion displaces the falx towards the right by 17mm, and a portion of the lesion extends beneath the falx. The lesion is lobulated in morphology with heterogeneous T1 and T2 signal and vivid post contrast enhancement. Portions of the lesion demonstrate diffusion restriction. The lesion results in significant mass-effect on the underlying frontal lobes, with extensive vasogenic oedema. Oedema also extends into the genu of the corpus callosum, which is compressed.
Both frontal horns of the lateral ventricles is are compressed, and the left lateral ventricular body dilated.
The anterior cerebral arteries are displaced toward the right around the mass. Multiple large parenchymal vessels appear to be feeding the lesion.
There is significant remodelling of the inner table of the left frontal calvarium, with marked thinning.
Appearance is most in keeping with a large frontal meningioma, which may be atypical in nature - differential diagnosis, given vascularity and feeding vessels includes haemangiopericytoma.