Glioblastoma NOS (splenium)

Case contributed by Dr Maxime St-Amant

Presentation

Altered mental state.

Patient Data

Age: 59-year-old
Gender: Male
CT

CT Brain

There is a left temporo-parieto-occipital lesion that transgresses the splenium of the corpus callosum. Associated vasogenic edema +/- cytotoxic edema involving the posterior parietal cortex. The most probable diagnosis is glioblastoma multiforme. There could be an associated stroke-like phenomenon, but it is most probably secondary to the tumor. MRI is suggested to confirm the diagnosis is this examination was realized without IV contrast.

MRI

MRI Brain

MRI confirms a large, heterogeneous, mass involving the left temporoparietooccipital lobes which extends across the splenium of the corpus callosum. There is a slight extension of the mass into the right occipital parenchyma. The lesion is partly solid, with necrotic & hemorrhagic (see the blooming on T2* GRE) components. Associated local mass effect & edema. The findings are compatible with glioblastoma multiforme.

There is no abnormal leptomeningeal enhancement.

Case Discussion

The diagnosis of GBM was confirmed on histology. Other differential diagnoses are less plausible. GBM is the most frequent corpus callosal tumor. Another tumor which can involve the corpus callosum is lymphoma, but it is not hemorrhagic/necrotic-like this, and it is hyperdense on CT.

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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Case information

rID: 19254
Published: 21st Aug 2012
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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