Presentation
Acute onset of right hemiparesis and hemianathesis with disturbed conscious level.
Patient Data
An irregular shape, ill defined, intra axial space occupying lesion is seen involving the posterior aspect of left temporal lobe. The lesion is surrounded by moderate perifocal oedema (grade II) and exerting significant mass effect in form of effacement of overlying sulci, compression of left aspect of brainstem and mildline shift to the right side of about 5 mm. It displays heterogeneous low signal on T1, iso signal on FLAIR and heterogeneous high signal on T2 with rim of diffusion restriction surrounding the lesion as well as marginal enhancement on post contrast images. MRS revealed inverted Cho/NAA ratio and significant lipid/lactate rise owing to intratumoural necrosis.
Case Discussion
A case of pathology proved glioblastoma. Although in this age group it is very likely that this is an IDH wild-type tumour, as its mutation status couldn't be identified so it is referred to as a glioblastoma NOS (not otherwise specified). Unfortunately, the patient died shortly from pulmonary infection.
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