Congenital glioblastoma

Case contributed by Ryan Thibodeau
Diagnosis certain


Persistent left frontal hemorrhage and hydrocephalus.

Patient Data

Age: 3 months
Gender: Male

There is a heterogeneously enhancing, lobulated mass with intratumoral cysts presumably arising from the left frontal horn. The solid component demonstrates restricted diffusion, consistent with hypercellularity. The mass extends across the midline and compresses the right frontal horn. The mass extends into the left greater than right anterior cranial fossa and left middle cranial fossa. Inferiorly, the mass causes mass effect and protrudes into the third ventricle. There are multiple intratumoral cysts suspected to contain blood products and proteinaceous material. The largest cyst measures 2.2 cm in the region of the right frontal horn. Anteriorly, the mass extends into the interhemispheric fissure and causes significant mass effect on the left frontal lobe. There is a large CSF space in the left anterior and middle cranial fossa, which likely represents porencephalic cysts in the left frontal lobe, which are displaced anteriorly and inferiorly. There may also be a superimposed arachnoid cyst in the left middle cranial fossa.

There is minimal hemorrhage layering in the occipital horns of the ventricles and enlargement of the ventricular system, particularly the lateral and third ventricles. The fourth ventricle is relatively normal in size. There is Wallerian degeneration in the left cerebral peduncle.

The anterior cerebral arteries are partially encased and displaced anteriorly by the mass. No narrowing of the anterior cerebral arteries. The left middle cerebral artery is displaced posteriorly and inferiorly. The middle cerebral arteries are patent.

Case Discussion

This is a case of an infantile glioblastoma.

Left frontal resection revealed a tumor with hyalinized vessels and rare mitoses. There were small foci of tumor necrosis and microvascular proliferation.

Immunohistochemical stains were positive for Vimentin and GFAP. These findings were consistent with a high-grade astrocytoma.

The patient had the mass resected and received chemotherapy and radiation.

The patient has been following up as an outpatient for >5 years.

Daniel Gewolb, MD

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.