High-grade glioma spreading along the corticospinal tract and corpus callosum

Right fronto-pareitalfrontal large infilterative space occupying lesion is showing heterogeneous signal with internal areas of cystic necrosis. The lesion shows internal patchy areas of diffusion restrictionseen spreading along the genu and patchy areasbody of contrast enhancement. It shows internal hemorrhagic foci, likely secondary to recent biopsy. It's surrounded by vasogenic edema and exerting mass effect. The lesion spreads along the corpus callosum reaching the contralateral left frontal lobe and spreadsalso spreading along the right corticospinal tract. The lesion elicits isointense signal on T1 WI and heterogeneous high signal on T2 WI showing small necrotic cystic areas at the genu of the corpus callosum and at the right deep frontal region. The lesion shows patches of diffusion restriction mainly seen he genu of corpus callosum, corticospinal tract and the high frontal region.

Linear track of cystic and hemorrhagic signal, and patchy contrast enhancement is seen at the right anterior frontal region, representing sequel of stereotactic intervention.

The lesion is surrounded by vasogenic edema and exerting positive mass effect.

Based on the radiological features of the lesion especially the extension of the lesion along the corticospinal tract and corpus callosum, as well as the aggressive features including necrotic cystic areas and patchy contrast enhancement, high grade glioblastoma was considered.