What is the grade of gliosarcoma in the present WHO classification of CNS cancers (2021)?
WHO grade 4.
A well-defined mass of altered signal intensity that is T2/FLAIR hyperintense, T1 hypointense with necrotic areas, with no restricted diffusion, in the left frontoparietal lobe, deep white matter, and gangliocapsular region. It is associated with surrounding T2/FLAIR hyperintensity extending in the white matter of the frontal parietal temporal lobe, internal capsule, and midbrain, likely vasogenic oedema. Post-contrast imaging shows enhancement in solid components and periphery.
A few foci of SWAN blooming within the mass are suggestive of haemorrhages. Mass effect in the form of effacement of the underlying left lateral ventricle and a midline shift of 5 mm.