Glioblastoma NOS (multifocal)

Case contributed by Dr Shirish Paul


History of seizures and right sided weakness.

Patient Data

Age: 60 years
Gender: Female

Cranial MR images show round to oval hypointense lesion in the left frontal lobe surrounded by perilesional oedema. Multiple small lesions are seen closely connected to the larger lesion by the hyperintense signal.Post contrast reveals peripheral discrete enhancement within the larger and smaller lesions. 


Histopathological images show two morphologic features essential for the diagnosis: necrosis and endothelial proliferation. The tumour shows serpiginous necrosis with palisading around necrotic foci.

Case Discussion

Multifocal glioblastomas are tumours which have multiple discrete areas of contrast enhancing tumour embedded with or connected by T2/FLAIR signal abnormality. They are considered to be part of one tumour.

The definitive treatment is surgery followed by gross total excision of the tumour.

This case was operated and sent for histopathological confirmation, proved to be 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: 50497
Published: 13th Jan 2017
Last edited: 21st May 2017
Inclusion in quiz mode: Included

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