54 y/o man with confusion.
A large, temporal lobe enhancing mass is noted with considerable surrounding edema and slight extension across the midline.
Forty to fifty percent of primary brain tumors are gliomas of which 50% are
glioblastomas. Glioblastomas occur most commonly in the fifth through seventh
decades. They usually develop in the cerebral hemispheres, most often the
frontal lobes. Glioblastomas grow as an irregular mass in the white matter
and is frequently seen to cross the corpus callosum to the opposite side
yielding a "butterfly" appearance.
MRI is useful in evaluating tumor extension and the presence of hemorrhage. Gadolinium enhancement is almost always present and usually appears ring-like around the tumor with thick, irregular walls. Enhanced MRI may also help distinguish tumor from surrounding edema. The prognosis is poor. Mean survival length after diagnosis is 8-10 months with less than 10% survival after 2 years.