A 4.1 x 3.8 x 3.3 cm extra-axial right anterior temporal lesion is again demonstrated, stable in size and morphology. This has features consistent with an epidermoid, with high T2 signal, incomplete FLAIR suppression and diffusion restriction, similar to adjacent white matter.
The lesion has a mass effect on the adjacent right temporal and inferior frontal lobes, with the right amygdala displaced superiorly. It abuts the temporal horn of the right lateral ventricle. The right hippocampus is slightly larger than the left, with preserved internal architecture - possibly postictal in nature.
Elsewhere no further lesions are identified.
Conclusion:
Large right middle cranial fossa epidermoid, which exerts mild mass-effect upon the adjacent temporal and inferior frontal lobes as well as resulting in displacement of the right amygdala.