Anaplastic astrocytoma (WHO grade III) of the septum pellucidum

Case contributed by Dr Chris O'Donnell

Presentation

1 - 2 weeks of unsteady gait with falling. No seizures.

Patient Data

Age: 70
Gender: Male

Large minimally enhancing mass arising from the septum pellucidum with oedema and possible infiltration into the body of the corpus callosum. Extension down to the foramina of Munro with resultant obstructive hydrocephalus (and periventricular oedema). Mass is bright on FLAIR with probable small cystic spaces. Note prominent adjacent vascularity.

Case Discussion

Highly unusual intraventricular mass arising from the septum pellucidum. In a younger patient central neurocytoma would be considered, however, it seems too aggressive for this condition with infiltration into the corpus callosum and the patient is too old (ie 70 years).

Histology: High grade glioma being GFAP +ve, p53 strongly positive in many enlarged atypical nuclei, Ki-67 proliferation index is ~25% with positive 1p/19q gene deletion.

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Case Information

rID: 39365
Case created: 1st Sep 2015
Last edited: 2nd Sep 2015
Inclusion in quiz mode: Included

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