Glioblastoma

Case contributed by Dr Nick Tarasov

Presentation

Presents with growing headaches and first episode loss of consciousness.

Patient Data

Age: 49
Gender: Male
Modality: MRI

There is a heterogeneous lesion located at the left tempo-parietal lobe. It has heterogenous signal intensities: mainly hyper on T2 and FLAIR images, iso-hypo on T1, no diffusion restriction.

Moderate vasogenic oedema more pronounced posteriorly.

Positive mass effect to the left basal ganglia, left lateral ventricle, midbrain and pons with midline shift 5mm.

After contrast injection it shows typically thick peripheral ring and irregular enhancement, with central non-enhancing large component, suggesting central necrosis, mild dural enhancement is also evident at the inferior part of left frontal lobe, well seen on coronal T1 fat suppressed images; the left lacrimal gland homogenous enhancement.

Small peripheral signal loss on axial EPI DWI with b=0 and slightly high signal on T1 at the small round area within tumour reflecting hemorrhagic component. 

Conclusion: 

The above finding are highly suspicious for a high grade primary brain neoplasm (GBM).  

 

Case Discussion

This patient underwent craniotomy with tumour resection and postoperative both chemo and radiotherapy. Pathology of resected tumour confirmed GBM (WHO grade IV).

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Case Information

rID: 39177
Case created: 24th Aug 2015
Last edited: 28th Aug 2015
Inclusion in quiz mode: Included

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