Glioblastoma NOS (butterfly morphology)
Headache and personality change.
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Extensive bifrontal tumour involving the corpus callosum associated with moderate vasogenic oedema.
Typical appearances of a butterfly glioma. The patient went on to have a biopsy.
MICROSCOPIC DESCRIPTION: Paraffin sections show fragments of a densely hypercellular glial tumour. Tumour cells are a mixture of fibrillary and gemistocytic astrocytes and several markedly pleomorphic multinucleated tumour giant cells are also noted. Scattered mitotic figures are identified. There are foci of necrosis as well as microvascular proliferation with endothelial cell hyperplasia.
FINAL DIAGNOSIS: Glioblastoma (WHO Grade IV).