High grade glioma, NOS grade 4


The lesion is seen involving the right temporal, insular, deep frontotemporal-parietal, and basal ganglia lesions, however, the posterior parietotemporal lesions show aggressive features such as diffusion restriction and heterogeneous patchy contrast enhancement.

Biopsy was obtained from the posterior deep periventricular and revealed grade 4 astrocytic tumor. 

In this instance, as IDH status has not been established it is not possible to distinguish between glioblastoma or a grade 4 astrocytoma IDH-mutant. However, the age group of the patient and the less aggressive features of the tumor seen involving the frontal and temporal lobes with lack of enhancement would suggest a malignant transformation of a low-grade astrocytoma or IDH mutant-grade IV astrocytoma.