This case illustrates typical appearances of a high-grade glioma (WHO IV, glioblastoma). The differential, especially in this patient, should almost always include a solitary metastasis which can appear very similar. MRI should thus be obtained whenever possible pre-operatively, as often it is able to distinguish between the two - for example, if there are typical features on MRS of glioma, or multiple smaller lesions consistent with other metastases.
Note: This case predates the recent (2016) revision WHO classification of CNS tumors and IDH status is not available. As such, this tumor would now be classified as a glioblastoma NOS.