Glioblastoma NOS (multicentric)

Case contributed by Dr Bahman Rasuli

Presentation

Seizure refractory to medical treatment.

Patient Data

Age: 65 years
Gender: Male
MRI

Multiple intra-axial space-occupying lesions of varying size and shape are seen in the left frontotemporal and parietal lobes, right frontal lobe as well as cerebellar hemispheres.

The largest lesion is seen in the left frontotemporal lobes measuring about 40*65 mm causing marked vasogenic edematous changes, mild pressure effect on the lateral ventricle and mid-line shift measuring about 5 mm.

There is intratumoral hemorrhage from a previous biopsy.

Most of the lesions display marginal enhancement after contrast administration.

Case Discussion

The diagnosis of glioblastoma was confirmed on microscopic examination. Sections showed astrocytic neoplastic tissue composed of highly pleomorphic cells with dysplastic nuclei, some bizarre nuclei, high mitotic activity, foci of spindling of tumor cells and fascicular pattern, foci of epitheliod appearance with gemistocytes features and infiltration of lymphohistiocytic and plasma cells between tumor cells. Vascular proliferation with glomeroloid pattern was noted. Large foci of necrosis with peripheral palisading also seen.

The diagnosis was a brain tumor at the left temporoparietal lobe resection with features suggestive of glioblastoma multiform with foci of sarcomatoid feature invading to bone tissue, WHO grade IV.

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Case information

rID: 71869
Published: 28th Oct 2019
Last edited: 31st Oct 2019
Inclusion in quiz mode: Included
Institution: Jame Jam Imaging Center

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