Presentation
Severe headache, recurrent attacks of seizure, and right-sided weakness.
Patient Data
There is an intra-axial mass at the left posterior -parietal lobe, it is mainly cystic with enhancing nodular irregular wall, the mass contains sub-acute blood with blood /fluid level, It surrounded by moderate vasogenic, finger-like edema exerting a mass effect, denoted by compression of the Lt trigone and occipital horn, mild transtentorial herniation with midbrain distortion and mild midline shift to right, Diffusion-weighted images show mild restriction in the wall of the lesion; and splenium of the corpus callosum.
MRS study showing :
- markedly increased choline & choline /Cr ration
- decreased NAA peaks
- increased lipids and lactate metabolites peaks
Case Discussion
The overall imaging findings are suggestive of a high-grade tumor, like glioblastoma multiforme, less likely cystic brain metastasis.
Cystic glioblastoma is a descriptive term for one form of glioblastoma that contains a large cystic component, rather than being a pathological subtype.
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