An enhancing mass lesion measuring 18 x 17 mm in the coronal plane, and 30 mm long in the right mesial temporal lobe, with another small anterior focus, is associated with a moderate amount of surrounding FLAIR hyperintensity that extends to involve cortex and amygdala. Posteriorly, it extends to the ventricular trigone, anteriorly to the posterior aspect of the inferior right frontal lobe, and superiorly to the right insula, internal and external capsules. Local mass effect, with sulcal effacement. The enhancement is associated with mild relative diffusion restriction. No susceptibility. Spectroscopy demonstrates elevated choline and probably also a small amount of lactate (noisy spectroscopy).
Findings are most in keeping with a primary right mesio-temporal tumour. GBM is favoured, but also consider PXA and ganglioglioma.