Presentation
Referral from another institution for pre-surgical imaging.
Patient Data
Large right temporal cystic/solid lesion with mass effect and compression of the right cerebral peduncle. Marginal rim enhancement around the margins of the cystic component. Solid elements on lateral margin, which enhance poorly and do not exhibit restricted diffusion.
The patient went on to have a resection.
Histology
MICROSCOPIC DESCRIPTION: A cellular infiltrate displaying variable nuclear hyperchromasia, angularity and pleomorphism, frequent mitotic figures and scant cell bodies, accompanied by a delicate fibrillary matrix which in part has a mucoid quality. Accompanied by a rich vasculature, including thrombosis, perivascular hyalinization and swelling and stratification of endothelium, the infiltrate is diffuse but for foci of palisading around occasional blood vessels or zones of necrosis. The lesion appears to reach the subarachnoid space. Part of the internal margin of the growth is present as a blurred interface with adjacent brain tissue.
FINAL DIAGNOSIS: glioblastoma.
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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