Centred at the grey-white matter junction of the right precentral gyrus is a peripherally enhancing lesion which demonstrates foci of susceptibility artefact on EPI, increased CBV and increased restricted diffusion peripherally. The lesion is surrounded by a large amount of white matter T2/FLAIR hyperintensity, that does not involve the overlying cortex. Mass effect is characterised by local cortical sulcal effacement and mild compression of the right lateral ventricle. No midline shift. Spectroscopy demonstrates a lactate peak.
The remainder of the brain is unremarkable.
Conclusion:
Right posterior frontal lesion is favoured to represent a metastasis. Foci of susceptibility artefact are in keeping with a hemorrhagic metastasis such as that which can be seen with melanoma.