Presentation
Convulsions and right numbness.
Patient Data
Right frontal cortical space occupying lesion eliciting isointense signal on T1WI and low signal on T2 & FLAIR WI. It shows faint marginal and small internal nodular enhancement. The lesion is surrounded by large vasogenic edema signal and exerts positive mass effect.
MRS criteria were those of neoplastic lesion with elevated Choline peak, Cho/Cr ratio, reduced NAA peak and elevated lipid/lactate peak.
Radiological features were suggestive of right frontal primary neopalstic lesion, possibly glioma/oligiodendroglioma.
Progressive course regarding the size, vasogenic edema and mass effect of the right frontal space occupying lesion.
Excision biopsy revealed glioblastoma WHO grade IV.
Case Discussion
Pathologically proven case of glioblastoma grade IV.
IDH status is not available. As such, this tumor would now (based on WHO 4th revised 2016 edition) be classified as a glioblastoma NOS.