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Glioblastoma NOS

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Sudden onset headache and reduced level of consciousness.

Patient Data

Age: 35 years
Gender: Female
ct

A large heterogenous hemorrhagic mass in the left thalamus is present with marked non-communicating hydrocephalus. 

mri

A large left thalamic mass is present with heterogeneous enhancement and central non-enhancement. Hemorrhagic components result in blooming. Ventricles have reduced in size and a craniotomy is now present. 

In a young patient in addition to a high grade glioma (GBM), which is the most likely diagnosis, one could entertain a pilocytic astrocytoma or less likely a metastases. 

Case Discussion

The patient went on to have a biopsy and third ventriculostomy (between CT and MRI) which confirmed the diagnosis of glioblastoma multiforme (GBM)

Note: IDH mutation status is not provided in this case and according to the current (2016) WHO classification of CNS tumors, this tumor would, therefore, be designated as a glioblastoma NOS

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