Glioblastoma NOS (recurrence and transependymal spread)
A patient with known glioblastoma underwent surgical excision and now presents for follow up.
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Left temporal area of encephalomalacia corresponds to the surgical site. There is local residual enhancing tumoural tissue which extends along the ependymal surface of the ipsilateral and contralateral ventricles with involvement of the genu of corpus callosum.
MRS reveals elevated choline, reduced NAA and increased lipid and lactate, confirming viable tumoural activity
Proven recurrent glioblastoma which shows transependymal CSF spread at the ependymal surface of the lateral ventricles.
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.