Low grade glioma underwent malignant degeneration

Case contributed by Dr Ahmed Abd Rabou

Presentation

Ataxia, dystonia and headache of long duration. CT was unremarkable

Patient Data

Age: 40 years
Gender: Male

A large ill defined infiltrative lesion is seen involving the right cerebellar hemisphere and extending through the middle cerebellar peduncle to involve the right hemipons. This lesion displays iso intense signal in T1 and hyperintense sginal in T2 with mild diffusion restriction as shown in DWI and ADC map. Post contrast study reveals a moderately enhancing nodule at the periphery of the right cerebellum however most of the lesion lack contrast enhancement.

Microscopy: diffuse astrocytoma (Fibrillary type) degenerated into anaplastic astrocytoma ( WHO Grade III)

Case Discussion

Diffuse astrocytomas are classified as WHO grade II tumors, which are low grade tumors with median survival of 6-10 years yet with intrinsic tendency to malignant transformation into anaplastic astrocytoma (WHO grade III) or GBM (WHO grade IV) 

Differential considerations for this case include ischemia, cerebritis and tumefactive demyelination.

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Case information

rID: 24522
Case created: 23rd Aug 2013
Last edited: 28th Feb 2016
Inclusion in quiz mode: Included

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