CT of the chest, abdomen, and pelvis found no indication of a systemic malignancy. Based on the neuroimaging findings and the clinical information, what is the most likely pathologic diagnosis (WHO CNS 5th edition)?
Glioblastoma, IDH-wildtype
- Right parietal lobe peripherally enhancing mass, maximal diameter 5 cm, with central necrosis and hemorrhage. The lesion and associated expansile FLAIR abnormality extends deeply, involving the retrolenticular white matter, posterior limb of internal capsule, and dorsolateral thalamus. Mass effect includes 2 mm leftward midline shift. Prominent draining medullary veins lateral to the mass.
- Two right superficial parotid masses, 1.2 cm and 1.4 cm, likely primary salivary gland neoplasms.
- Chronic microhemorrhage in the left centrum semiovale underlying the precentral gyrus
- Mild, scattered T2/FLAIR hyperintensities in the subcortical and periventricular white matter are nonspecific but likely reflect chronic small vessel disease in a patient of this age.