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Case #19

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Demographics: 62 years old, Female
Indication: ? cerebrovascular accident

Findings

  • Large enhancing mass with areas of central hypoenhancement involving the posterior left frontal lobe, superior left temporal lobe, and anterior left parietal lobe measuring 5 x 4.5 x 4.5 cm with surrounding white matter T2/FLAIR hyperintensity and multiple nearby satellite enhancing lesions
  • The medial margin of the mass abuts the ependymal surface of the atrium of the left lateral ventricle
  • Associated mass effect with local sulcal effacement, crowding of the left lateral ventricle, and left to right midline shift measuring 7 mm
  • Dilation of the temporal horn of the left lateral ventricle
  • No evidence of acute infarct, hemorrhage, or downward transtentorial herniation

Diagnosis

High grade glioma

Sample Report

Large enhancing, centrally necrotic mass involving the posterior left frontal lobe, superior left temporal lobe, and anterior left parietal lobe with surrounding white matter T2/FLAIR hyperintensity and multiple nearby satellite enhancing lesions, which is concerning for a high grade glioma. The medial margin of the mass abut the ependymal surface of the atrium of the left lateral ventricle, raising the risk for ependymal spread. Recommend neurosurgical evaluation.

Associated mass effect with local sulcal effacement, partial effacement of the left lateral ventricle with entrapment of the left temporal horn, and left to right midline shift measuring 7 mm.

No evidence of acute infarct, hemorrhage, or downward transtentorial herniation.

Discussion

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