These MRI findings are in keeping with an intracranial epidermoid cyst.

This patient has a large intracranial epidermoid cyst, which is a congenital lesion with an estimated prevalence about 1% of all intracranial tumors. This lesion was symptomatic and causes mass effect mainly on the cerebellum. It is difficult not to underestimate the value of DWIs - these are short but helpful sequences, especially in identifying epidermoids. So, the use of contrast-enhanced study in this case was doubtful.