PMC5671696_01
Axial T2-weighted image demonstrating heterogeneous mass in the right parasagittal parietal lobe with extensive surrounding vasogenic edema.
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A brain magnetic resonance imaging (MRI) showed an irregularly enhancing mass measuring 5.8 cm anteroposterior x 3.2 cm transverse x 4.4 cm craniocaudal within the right parieto-occipital lobe, with significant vasogenic edema (Figures 1() and 2()).
Brain surgical specimen. High-grade glioma with foci of necrosis and microvascular proliferation consistent with glioblastoma multiforme (WHO Grade IV).
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The surgical pathology report showed a high-grade glioma with foci of necrosis and microvascular proliferation consistent with GBM (WHO Grade IV) (Figure 3()).
Coronal T1- (left) and T2- (right) weighted images approximately 6 months following resection demonstrating extensive neoplastic lesions throughout both femurs, iliac bones, and the sacrum.
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MRI, he was hospitalized with excruciating lower back pain radiating to his right hip and anterior thigh. MRI of the pelvis showed extensive lesions with involvement of femurs, iliac bones, and sacrum (Figure 4()).
GBM osseous metastasis (higher power). Microscopic sections showing a destructive cellular neoplasm with highly atypical and hyperchromatic tumor cells, abundant necrosis, and vascular proliferation.
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A biopsy of a right femoral lesion showed numerous tumor cells in a reactive stroma replacing much of the bone marrow (Figure 5()).
GBM with GFAP stain. GFAP (glial fibrillary acidic protein) immunohistochemical stain showing strong staining within the fibrillary cytoplasmic processes of the viable tumor cells.
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The tumor cells stained positive for glial fibrillary acidic protein (GFAP) (Figure 6()).