Glioblastoma NOS and past demyelination

Case contributed by Austin Neuropathology

Presentation

Middle aged woman with a previous diagnosis (poorly established) of MS, now presents with left sided hemiparesis.

Patient Data

Age: Middle age
Gender: Female

MRI brain

Modality: MRI

MRI of the brain demonstrates extensive poorly defined areas of white matter hyperintensity with a distribution consistent with demyelination. 

In the posterior right frontal lobe and parietal lobe a mass with surrounding vasogenic-type oedema is present which demonstrates solid if somewhat heterogeneous contrast enhancement. Further contrast enhancement is seen tracking along the occipital and temporal horn of the lateral ventricle. 

MRI cervical spine

Modality: MRI

Imaging of the spinal cord confirms typical appearances of demyelination. 

Case Discussion

This finding above all others strongly suggests that this lesion represents a tumour (most likely a glioma) rather than tumefactive demyelination. This was confirmed on histology which demonstrated a glioblastoma

Note: IDH mutation status is not provided in this case and according to the current (2016) WHO classification of CNS tumours, this tumour would, therefore, be designated as a glioblastoma NOS

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Case Information

rID: 10546
Case created: 21st Aug 2010
Last edited: 24th May 2017
Tags: ms, gbm
Inclusion in quiz mode: Included

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