Expansile T2 hyperintense mass involves the left anteromedial temporal lobe, insular, basal ganglia and corona radiata, as well as the left thalamus. Better appreciated on the T2 than the flair sequences, there is also hyperintensity in the medial right temporal lobe which is consistent with contralateral spread of tumour along unexpanded rostrum of corpus callosum. There are 2 separate regions of focal enhancement, in the anterior aspect of the basal ganglia and in the left posterior insula, both with corresponding high-grade features of elevated cerebral blood volume and ADC reduction.
The degree of expansion related to the tumour has slightly increased and the two nodular enhancing foci are new.