Locally Aggressive Glioma in a 55-Year-Old Female

摘要

A 55-year-old woman attended the Department ofRadiologyandImaging in Enam Medical CollegeHospital for MRI of brain with the history ofconvulsion and memory loss for 15 years andunconsciousness for last 2 months. MRI reveals afairly large (86 cm × 74 cm × 66 cm) enhancing wellcircumscribed T1WI hypointense, T2WI isointenseand FLAIR hyperintense mass involving left temporoparietal lobe with midline shifting towards right side.Few T1WI hypo, T2WI and FLAIR hyperintense fociwere seen within the mass indicating mild necrosis.There was no evidence of calcifcation and perilesionaledema. The mass caused effacement of left lateralventricle, 3rd ventricle, adjacent sulci-gyri withdilatation of right lateral ventricle. There is herniationof the mass into contralateral hemisphere behind 3rdventricle. There is no evidence of invasion of the massinto adjacent brain parenchyma and ventricles. DWIshows no restriction in diffusion. MRS shows mildalteration of choline-creatine ratio. MRA shows thatMCA and ACA are compressed and displaced but noinvasion and encroachment of vessels. MRV showshypoplastic left transverse and sigmoid sinuses. Thismass was diagnosed as well-circumscribed locallyaggressive glioma with mass effect. Differentialdiagnoses included lymphoma and meningioma.