A large, heterogeneous mass is located in the right frontal lobe with
surrounding edema and mild subfalcine midline shift.
On post contrast images, a thick enhancing rim is seen. There is also some
restricted areas of diffusion present within the mass.
MRS demonstrates markedly elevated lactate and lipids within the mass.
No abnormally elevated choline is seen. Of note, elevated ketone levels are
seen in the reference region of the brain parenchyma as well as in the mass.
Key words: mri infection metabolic mrs