Bilateral thalamic glioma
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Bilateral thalamic mass, larger on the left side, extending to the left lentiform nucleus, and amygdala, of low signal intensity on T1WI, high signal intensity on T2WI, and FLAIR with no surrounding edema or enhancement seen on postcontrast sequences. There is a mass effect on the 3rd ventricle with mild dilatation of the lateral ventricles (bi-ventricular hydrocephalus).
MRS shows an elevation the choline/creatine, and choline/NAA ratios with a myo-inositol spike, indicating most likely a low-grade glioma.
MRI appearance highly suggestive of bilateral thalamic glioma