 There is a large infiltrating T2 hyperintense mass centered within the body of the corpus callosum extending to involve the cingulate gyrus and thalami bilaterally along the corticospinal tracts. The mass measures approximately up to 4.8 x 4.1 cm in the axial plane with moderate mass effect upon the body of the lateral ventricles. There is no hydrocephalus. There are multiple areas of peripheral enhancement and central necrosis. There are additional T2 hyperintense lesions demonstrating patchy enhancement within the right inferior frontal gyrus/precentral gyrus laterally as well as the left temporal lobe. Portions of the enhancing tissue demonstrate mild diffusion restriction and the majority of the lesions demonstrate markedly elevated relative cerebral blood volume. There is minimal susceptibility effect associated with the callosal lesion compatible with blood products.There is no evidence of acute infarct. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable.
Large infiltrating necrotic mass centered within the callosal body with additional lesions in the right frontal and left temporal lobes. The appearance is most compatible with multifocal grade 4 astrocytoma.