Case 004

History/Physical

History/Physical:

77-year-old right-handed male.

Increasing headache over five weeks.

There is a large ill-defined intra-axial mass arising from the left frontal lobe (arrows). There is significant mass effect. Subfalcine shift is present.

Post-contrast, there is irregular rim and central enhancement (arrows). Note that the enhancing component of the mass does not correspond to the full outer extent of low T1 signal on the unenhanced image. Note the blurriness of the image from motion artifact.

The mass has high signal on T2. The margins are difficult to delineate (arrows). There is high T2 signal at the margin of the lateral ventricles posteriorly. This could be transependymal CSF flow from obstructive hydrocephalus due to compression at the foramen of Monro.

Diagnosis: Gliobastoma, IDH-wildtype (WHO grade 4)