This intra-axial tumor is a ring-enhancing lesion, which has a fairly broad differential.

It has a nodular wall which is more common in a neoplasm. The ring is complete, making demyelination less likely. There is a diffusion restriction in the wall which favors a highly cellular tumor like glioblastoma. The fluid content doesn't show diffusion restriction making an abscess unlikely and instead, a tumor with a central necrosis a more likely diagnosis. The smaller lesion adjacent to the bigger, primary lesion favors multifocal glioblastoma.

Biopsy confirmed the diagnosis of glioblastoma multiforme, IDH wildtype.