Patient Data
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A NCCT was conducted to exclude stroke, however, the NCCT revealed bilateral thalamic hypodense lesions associated with significant vasogenic edema. Contrast was given and revealed enhancement of these hypodense lesions.
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MRI was performed and shows bilateral thalamic lesions which are of predominantly low signal intensity on T1 and predominantly of high signal on T2. These lesions shows thick somehow nodular enhancement, and are embedded within a region of high T2 signal which appears to reach accros the corpus callosum from one side to the other.
Case Discussion
Biopsy of one of the lesion revealed glioblastoma (WHO grade IV). Give the location of the lesions and probable (albeit subtle) connecting T2 signal abnormality, this likely represents a multifocal rather than multicentric 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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