The patient went on to have surgery.
Histology:
MICROSCOPIC DESCRIPTION: The paraffin sections show fragments of cerebral cortex and white matter with non-specific reactive changes only. No evidence of tumour is seen. Paraffin sections of other samples show fragments of densely hypercellular astrocytic glioma. Tumour cells show moderate nuclear and cellular pleomorphism with spindle, epithelioid and gemistocytic forms noted. Frequent mitotic figures are identified and there are several foci of vascular endothelial hyperplasia. In addition, there are areas of both confluent and palisaded necrosis. Several of these areas contain thin walled necrotic and thrombosed blood vessels. The features are of glioblastoma multiforme.
FINAL DIAGNOSIS: Glioblastoma
Note: IDH mutation status is not provided in this case and according to the current (2016) WHO classification of CNS tumours, this tumour would, therefore, be designated as a glioblastoma NOS.
A two-week post-operative scan was taken to assist with adjuvant therapy treatment planning.