Glioblastoma (IDH wild-type)

Case contributed by Derek Smith


New onset headache, with progressive slurring of speech and confusion. Left leg weakness reported.

Patient Data

Age: 70 years
Gender: Male

5 x 5 x 4 cm ring enhancing lesion in the right frontal lobe, with extension across the corpus callosum.

Moderate perilesional reduced attenuation and mass effect with effacement of the anterior right lateral ventricle. Patent basal cisterns.


Body CT performed at the same time did not demonstrate malignancy elsewhere.

Same day MRI (no interval treatment)


Solitary 5 cm right frontal lobe mass, crossing the anterior corpus callosum. The mass also extends to the ependymal surface at the right lateral ventricle.

Thick enhancing wall with non-enhancing center, probable necrosis. No central increased diffusion signal, excluding abscess formation.

Local white matter FLAIR hyperintensity with mass effect as on CT.


Appearances, with unremarkable staging CT and with the lesion crossing the midline, favor a high grade glial series tumor.

Case Discussion

Initial treatment was with oral steroids and the case was referred for tertiary opinion.

Surgical biopsy confirmed unmethylated glioblastoma WHO grade IV, IDH1 wild-type.

This case was subsequently managed by radiotherapy, with partial response.


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