Glioblastoma NOS (multicentric)

Case contributed by Dr Ahmed Abd Rabou

Presentation

Headache, vertigo, and recurrent vomiting. Previous MRI revealed multiple intracranial mass lesions and biopsy was taken from the largest one

Patient Data

Age: 60-year-old
Gender: Female
MRI

MRI Brain

There are multiple variable size and shape intra-axial space occupying lesions seen in the left frontal lobe and the parietal lobes bilaterally. The largest lesion is seen in the right parietal region and extends through the splenium of the corpus callosum to the contralateral side. There is intratumoral haemorrhage from a previous biopsy and extracranial herniation through a craniotomy defect. All lesions display marginal enhancement after contrast administration.

Case Discussion

Histopathology of the largest lesion revealed WHO grade IV glioblastoma with pleomorphic astrocytes and marked atypia and mitotic figures. The frontal lesion does not appear to be connected to the occipital lesions by abnormal T2 signal, and thus the term multicentric glioblastoma would be favoured over multifocal. 

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: 36599
Case created: 1st May 2015
Last edited: 26th May 2017
Inclusion in quiz mode: Included

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