Case contributed by Dr Trent Orton

Patient Data

Age: 66 years
Gender: Female
Modality: CT

Enhancing cortical mass near the central sulcus. 

Modality: MRI

Heterogeneously enhancing right parietal mass. 

Case Discussion

Patient went on to have a craniotomy and excision. 


Microscopic Description:

Sections show multiple fragments involved by a very cellular neoplastic process. For the most part, the tumor cells are spindly with significant pleomorphism and hyperchromasia accompanied by microvascular proliferation. Geographic areas of necrosis are seen. There are a significant number of neutrophils at the interface between viable tumor and necrosis. The tumor cells also assume a microgemistocytic appearance in some areas. Mitotic figures are identified, particularly in the frozen sections. In some areas, tumor is seen within the Virchow-Robin spaces. Special stains (reticulin and Masson trichrome) show that the collagen fibers are limited to blood vessels, and there is absence of reticulin fibers around individual tumour cells. Immunohistochemically, the malignant cells react strongly to GFAP (glial acidic fibrillary protein) with a significant number labelled by MIB-1 nuclear stain.

Final Diagnosis:

Glioblastoma multiforme

The tumor is comprised almost exclusively of cells with astrocytic lineage and shows high grade features. There are rare microgemistocytes in the biopsy of the tumor, raising the possibility of a oligodendroglial component; but this is minor, at least in this sample of the tumor.


Given the extensive cortical involvement and apparent cortical epicenter of the tumour an underlying oligodendroglial component seems a reasonable assumption. 



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Case Information

rID: 4925
Case created: 4th Nov 2008
Last edited: 5th Nov 2016
Inclusion in quiz mode: Included

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