A50-year-old man with a medical history notable only
for hypercholesterolemia developed a generalized
tonic-clonic seizure while at work. Family history was significant
for a father who had onset of Alzheimer disease
at age 71 years. Computed tomography of the head initially
suggested a right frontal hemorrhage, and magnetic
resonance imaging showed a well-circumscribed right
frontal lesion (Figure, A) with features suggestive of a
brain tumor. On computed tomography, it was 4 to 5 cm
in size, with subtle ring enhancement, mild edema but
negligible mass effect, and signs of calcification. A multi