Presentation
Seizure.
Patient Data
There is a right parietal lobe lobulated and heterogeneous mass which shows necrotic central areas and peripheral enhancement after contrast administration. It causes also local mass effect compressing the right lateral ventricle and with a mild left midline shift.
The lesion is now better demonstrated as involving the right portion of the splenium of the corpus callosum, posterior portion of the cingulate gyrus and part of precuneus. Ir relatively spared the cortex. Small foci of blooming artefact on the gradient express minor hemorrhagic component. Contrast enhancement is again demonstrated, and the tumor shows also diffusion restriction.
Case Discussion
The features demonstrated on the MRI helps to put a glioblastoma as the first hypothesis. Glioblastomas have a preferential spreading along the condensed white matter tracts such as corticospinal tracts and corpus callosum.
The case was histologically confirmed as glioblastoma (WHO grade IV).
Note: IDH mutation status is not provided in this case and according to the current (2016) WHO classification of CNS tumors, this tumor would, therefore, be designated as a glioblastoma NOS.
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