Disorder of brain, unspecified [G93.9], Reason for Study: ^Reason: pre-op for crani History: brain lesion Multiple fiducial markers attached to skull focal the stealth protocol MRI.There are multiple rim-enhancing intra-axial masses involving right thalamus, posterior aspect of basal ganglia as well as insular. Associated brain edema is seen and extends through the right cerebral peduncle reaching to the level of the right midbrain. There is minimal midline shift toward left side.The largest lesion was measured as 27.2 mm x 31.8 mm. Small daughter nodules are seen adjacent to the largest lesion involving the right thalamus and right frontal lobe (series 401, image 130).The ventricles, sulci and cisterns are unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear.Mucosal thickenings on ethmoid sinus are seen.
Right thalamic rim enhancing lesion associated with multiple small enhancing nodules and extensive surrounding brain edema involving right thalamus, right basal ganglia and right frontal lobe indicating malignant process. Differential diagnosis include high grade glioma or metastatic lesions more likely, less likely differential diagnosis include lymphoma or inflammatory/infectious process. 