The patient went on to have an MRI (not shown) which favoured a high grade glioma, and soon after had a craniotomy and de-bulking of the tumour.
Histology
MICROSCOPIC DESCRIPTION: Paraffin sections show fragments of a densely hypercellular astrocytic glioma. Tumour cells show moderate nuclear and cellular pleomorphism and are a mixture of fibrillary and gemistocytic forms. Many cells also show lipidisation of their cytoplasm. Frequent mitotic figures are identified and there are numerous areas of both confluent and palisaded necrosis. Many of these include thin walled thrombosed and necrotic vascular channels. There is also prominent vascular endothelial cell hyperplasia. The features are of a glioblastoma.
FINAL DIAGNOSIS: Glioblastoma - WHO grade IV