Presentation
Intractable headache and history of craniotomy two months ago.
Patient Data
Right parietal craniotomy
Irregular heterogenous partially-enhancing intra-axial mass, with a cystic/necrotic component ( 35*41*46 mm ), prominent vasogenic oedema and involvement of occipital horn of lateral ventricle.
High signal foci in T2 and FLAIR sequences in the subcortical and periventricular the white matter of both cerebral hemispheres depicts microvascular ischaemic events.
Case Discussion
Microscopic:
The brain glial tumour is extensively necrotic with palisading of tumour cells, areas of haemorrhage and microvascular proliferation. The tumour is moderately cellular, composed of atypical cells and many gemistocytes.
Diagnosis:
Glioblastoma, NOS, WHO grade IV.