Recurrent high-grade glioma

Case contributed by Dr Bruno Di Muzio

Presentation

Second year of surveillance and follow-up after standard treatment for a oligoastrocytoma (WHO III).

Patient Data

Age: 48
Gender: Male
MRI

MRI Brain

Previous right temporal craniotomy and underlying resection cavity noted. The extent of surrounding FLAIR hyperintensity is similar when compared to the most recent and the earlier scan performed last year. A 3 mm nodule of enhancement at the medial aspect of the resection cavity has been gradually increasing in size, and has increased CBVa. No other abnormal/nodular contrast enhancement.

Spectroscopy trace obtained is fairly unremarkable (not shown). 

There are no new parenchymal foci of signal abnormality. The ventricles and basal cisterns are within normal limits. No intra or extra axial collection.

IMPRESSION: Mostly stable appearances, with growth of a small (3mm) nodule of enhancing tissue at the medial margin concerning for tumour recurrence.

Annotated image

A 3 mm nodule of enhancement (arrow) at the medial aspect of the resection cavity has been gradually increasing in size, and has increased CBVa. 

Case Discussion

This cases illustrates a typical appearance of a glioma recurrence characterized by a new enhancing lesion in the resection cavity border.

 

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Case information

rID: 34626
Case created: 2nd Mar 2015
Last edited: 10th Sep 2015
Tag: rmh
Inclusion in quiz mode: Included

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