The significance of lack of MR contrast enhancement of supratentorial brain tumors in adults: histopathological evaluation of a series.
BACKGROUND
To correlate magnetic resonance imaging (MRI) findings of non-enhancement of supratentorial brain neoplasms in adults with histopathologic findings.


METHODS
Forty adult patients whose preoperative MRI studies demonstrated a non-enhancing supratentorial brain neoplasm were identified retrospectively. Biopsy material for all patients was then reviewed by a board-certified neuropathologist.


RESULTS
Histopathologic examination identified 24 (60%) low-grade gliomas: 4 (10%) low-grade astrocytomas, 10 (25%) low-grade gliomas (not further classified), 8 (20%) low-grade oligodendrogliomas, and 2 (5%) low-grade mixed oligoastrocytomas. However, 16 (40%) nonenhancing lesions were classified as anaplastic gliomas: 12 (30%) anaplastic astrocytomas, 1 (2.5%) anaplastic mixed oligoastrocytoma, 1 (2.5%) anaplastic oligodendroglioma, and 2 (5%) anaplastic infiltrating gliomas of indeterminate subtype.


CONCLUSIONS
Non-enhancement of supratentorial brain neoplasms in adults does not equate with low-grade malignancy. This fact should be taken into account when biopsy and treatment are being planned in patients with nonenhancing brain tumors. More aggressive and/or surgical therapy might be indicated for such lesions, particularly those in the nondominant hemisphere or nonmotor areas.
Ginsberg
L E
LE
Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Fuller
G N
GN
Hashmi
M
M
Leeds
N E
NE
Schomer
D F
DF
D000328:Adult; D000368:Aged; D005260:Female; D005910:Glioma / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000473:pathology*