Glioblastoma NOS spreading to the corticospinal tract

Case contributed by Dr Nick Tarasov

Presentation

2 months of the left sided hemiparesis treated as a stroke.

Patient Data

Age: 50 years
Gender: Male

Irregularly shaped mass involving both right pre/postcentral gyri with inhomogeneous inner architecture.

Mild vasogenic edema, mild mass effect to the right ventricle.

Vivid enhancement elevated CBV and CBF and diffusion restriction of the solid component.

The right proximal portion of corticospinal tract fibers involved, best seen on the post contrast coronal images, at the level of tentorium cerebelli.

Case Discussion

This case well demonstrates how glioma cells can migrate along myelinated white matter fiber tracts and also shows an important role of MRI examination among patients with a possible stroke signs.

A primary brain tumor is one of the several clinical presentations for a 'stroke mimic'.

Note: As this case does not provide a histological diagnosis of IDH mutation status, according to the current (2016) revision WHO classification of CNS tumors this tumor would be classified as a probable glioblastoma NOS.

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Case information

rID: 51438
Published: 19th Feb 2017
Last edited: 21st May 2017
Inclusion in quiz mode: Included

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