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

The case illustrates features of glioblastoma, especially spreading along the condensed white matter tracts such as corticospinal tracts and corpus callosum to involve the contralateral hemisphere.

Also the case shows aggressive features such as areas of cystic necrosis, and patchy diffusion restriction. Areas of diffusion restriction helps to identify ares of high grade transformation and contrast enhancementto discriminate the lesion from the surrounding vasogenic edema.

Glioblastomas have traditionally been divided into primary and secondary; the former arising de novo (90%) without a pre-existing lower grade diffuse astrocytoma and they tend to occur in older individuals, whereas the latter developed from a pre-existing lower grade diffuse astrocytoma (10%), they tend to occur in younger patients, and of uncertain significance, they have a predilection for the frontal lobes.

Anaplastic astrocytomas are WHO grade III lesions, with imaging appearances and prognosis between those of diffuse low-grade astrocytomas (WHO grade II) and glioblastomas (WHO IV),