Presentation
Epilepsy and headache.
Patient Data
Computer tomography carried out just under a year before demonstrates a hypodense lesion compromising the right superior frontal gyri.
An expansive and infiltrative intra-axial lesion that involves the cortex and subcortical regions is identified in the right superior frontal gyrus, with extension to the deep white matter and the corona radiata. An expansive effect is observed, determining a reduction in the amplitude of the adjacent CSF spaces.
There is no blooming artifact on SWI.
The lesion shows hyperintensity on T2 and FLAIR and hypointensity on T1.
There is a small area of restricted diffusion next to the right superolateral contour of the lesion, with a low signal on the ADC map and a slightly lower signal intensity is observed on T2, which may represent a lesional zone with a component of greater cellularity.
Small vascular structures are observed throughout the lesion, however, no obvious signs of intralesional blood-brain barrier breakdown are defined.
Case Discussion
This case demonstrates imaging findings of an oligodendroglioma. The patient underwent surgical resection.
Immunohistochemistry
IDH-1: strong immunoreactivity; GFAP: strong/moderate immunoreactivity; Ki67: nuclear immunoreactivity positive in up to 15% of neoplastic cells; P-53: positive, multifocal; CK-PAN: negative. OLIG-2: positive, diffuse; ATRX: positive.
Conclusion
Histological and immunohistochemical picture compatible with oligodendroglioma (WHO grade III).
A 1p19q co-deletion search was not made.
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