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Glioblastoma Multiforme

Graham JWG - MedPix

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Affiliation: Madigan Army Medical Center

ABSTRACT

Diagnosis: Glioblastoma Multiforme

History: 61 year old white male with 2 weeks of difficulty concentrating and remembering, slower movements. High blood pressure, otherwise healthy, though wife has noticed subtle changes in mentation over last 6 months

Findings: CT: Low attenuation focus in the post left parietal lobe, with surrounding vasogenic edema. Second lesion in the left temporal lobe, with irregular central high attenuation consistent with hemorrhage. There is not a clear connection between the two discrete lesions. The cerebral sulci and left lateral ventricle are effaced, and there is mild midline shift. MR: Left posterior parietal and left temporal lesions with peripheral enhancement, and surrounding vasogenic edema. The temporal lesion has very low central signal on T2 weighted images. Mass effect as seen on CT.

Ddx: DDx: The primary differential for most brain lesions is metastatic disease vs. primary malignancy vs infection (abscess). A mnemonic for ring enhancing lesions is MAGICAL DR: Metastatic Disease – may favor due to multiplicity and hemorrhage Abscess/Cerebritis – hemorrhage would be atypical,and not febrile GBM – multicentric GBM also common, and can hemorrhage Ischemic: Hemorrhagic stroke – despite known hypertension, unlikely to have defined enhancing tissue Contusion – no history of trauma, and unlikely with enhancing soft tissue mass AIDs: Toxo – no history to suggest Lymphoma – would be atypical in an otherwise healthy individual Demylinating Disease – hemorrhage would be uncharateristic, and not comon Radiation Necrosis – no history of radiation therapy

Dxhow: Biopsy

Exam: Not available

No MeSH data available.


MR: Left posterior parietal and left temporal lesions with peripheral enhancement, and surrounding vasogenic edema. The temporal lesion has very low central signal on T2 weighted images. Mass effect as seen on CT.
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MPX2266_synpic21024: MR: Left posterior parietal and left temporal lesions with peripheral enhancement, and surrounding vasogenic edema. The temporal lesion has very low central signal on T2 weighted images. Mass effect as seen on CT.


Glioblastoma Multiforme

Graham JWG - MedPix

MR: Left posterior parietal and left temporal lesions with peripheral enhancement, and surrounding vasogenic edema. The temporal lesion has very low central signal on T2 weighted images. Mass effect as seen on CT.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2266&req=5

MPX2266_synpic21024: MR: Left posterior parietal and left temporal lesions with peripheral enhancement, and surrounding vasogenic edema. The temporal lesion has very low central signal on T2 weighted images. Mass effect as seen on CT.

View Article: MedPix Image - MedPix Case

Affiliation: Madigan Army Medical Center

ABSTRACT

Diagnosis: Glioblastoma Multiforme

History: 61 year old white male with 2 weeks of difficulty concentrating and remembering, slower movements. High blood pressure, otherwise healthy, though wife has noticed subtle changes in mentation over last 6 months

Findings: CT: Low attenuation focus in the post left parietal lobe, with surrounding vasogenic edema. Second lesion in the left temporal lobe, with irregular central high attenuation consistent with hemorrhage. There is not a clear connection between the two discrete lesions. The cerebral sulci and left lateral ventricle are effaced, and there is mild midline shift. MR: Left posterior parietal and left temporal lesions with peripheral enhancement, and surrounding vasogenic edema. The temporal lesion has very low central signal on T2 weighted images. Mass effect as seen on CT.

Ddx: DDx: The primary differential for most brain lesions is metastatic disease vs. primary malignancy vs infection (abscess). A mnemonic for ring enhancing lesions is MAGICAL DR: Metastatic Disease – may favor due to multiplicity and hemorrhage Abscess/Cerebritis – hemorrhage would be atypical,and not febrile GBM – multicentric GBM also common, and can hemorrhage Ischemic: Hemorrhagic stroke – despite known hypertension, unlikely to have defined enhancing tissue Contusion – no history of trauma, and unlikely with enhancing soft tissue mass AIDs: Toxo – no history to suggest Lymphoma – would be atypical in an otherwise healthy individual Demylinating Disease – hemorrhage would be uncharateristic, and not comon Radiation Necrosis – no history of radiation therapy

Dxhow: Biopsy

Exam: Not available

No MeSH data available.