Presentation
Intractable seizure and history of craniotomy 12 months ago.
Patient Data
MRI demonstrates a large heterogenous signal intra-axial solid necrotic mass lesion in the left frontal and parietal-temporal lobes.
It exerts a significant mass effect with a midline shift, uncal herniation, compression of the left lateral ventricle occipital horn, and dilatation of the temporal horn, and is surrounded by vasogenic edema.
Invasion to the splenium of corpus callosum and midline cross of tumoral mass lesion is seen.
The lesion shows patches of diffusion restriction and heterogenous post-contrast enhancement.
The patient underwent brain tumor surgery one year ago. Biopsy confirmed this as a glioblastoma multiform, IDH wild type, WHO grade IV.
IHC results:
ATRX: positive
GFAP: positive
P53: positive
IDH1: negative
Case Discussion
The recent patient was referred with a flare-up of symptoms such as intractable seizure and headache.
Based above imaging findings, the recurrence of the known brain tumor should be considered.
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