In the left frontal lobe, mainly in a sub-cortical region is an irregular ovoid shaped cystic lesion. It has a smooth outer border and internal nodular inner surface. It displays low to intermediate signal intensity in T1 and heterogeneous high signal intensity in T2. On post-contrast series, it shows intense marginal nodular non-uniform contrast enhancement (ring enhancement) and central non-enhancing component. In DWI and ADC, its centre shows facilitated diffusion with mild diffusion restriction. It is surrounded by minimal vasogenic oedema pattern. Both exert a mild mass effect in the form of effacement of the overlying cortical sulci & compression on the frontal horn of the ipsilateral lateral ventricle as well as minimal midline shift. Medially the SOL is seen indenting the left frontal rectus gyrus. Posteriorly the SOL is seen buckling the left aspect of the genu of the corpus callosum. It measures about 5.2 x 3.7 x 3.4 cm along its maximum AP, transverse and craniocaudal dimensions respectively. No supratentorial hydrocephalic changes.
A right high parietal convexity extra-axial cyst is seen with no related contrast enhancement or diffusion restriction measuring 2.5X1.9X2.4 cm along its maximum AP, transverse and craniocaudal dimensions respectively (arachnoid cyst).
The MRS voxel was placed at the SOL and showed elevated Cho peak, Cho/NAA and Cho/Cr ratio, moderately elevated Myoinositol peak and elevation of the lipid/lactate peak.