Presentation
Chronic headaches and new-onset seizures.
Patient Data
A large right frontotemporal solid mass lesion with central low density and multiple intratumoral high densities due to calcifications.
The lesion is isodense peripherally to gray matter.
The mass effect upon the right lateral ventricle with a midline shift measuring about 8 mm.
No obvious surrounding vasogenic edema as well.
Right frontotemporal craniotomy
Edema and hematoma at right frontotemporal lobes, thalamus, and basal ganglia
Pneumocephalus.
Pathology report was anaplastic oligodendroglioma (WHO grade III).
Gross pathology image courtesy of Dr .hosseini, Qeshm Hospital.
Case Discussion
FINAL DIAGNOSIS: Anaplastic oligodendroglioma - WHO Grade III.
Anaplastic oligodendroglioma is a WHO grade III diffuse infiltrating glioma that has histological features of anaplasia, and molecular markers consistent with an oligodendroglioma (1p19q co-deletion and IDH mutation) as per the current (2016) WHO classification of CNS tumors 1. They make up 20-50% of all oligodendrogliomas.
As the molecular status is unavailable then the diagnosis relies on histology alone and is given the designation oligodendroglioma NOS (grade 3).
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