High grade glioma in a focal cortical dysplastic lesion.
A 61-year-old woman presented in 1999 with a recent onset of left-sided focal clonic seizures with associated vague speech arrests. A computerised tomography (CT) scan revealed a hypoattenuated non-enhancing lesion within her right temporal lobe which was biopsied and the histopathological features were reported to be consistent with a hamartoma, reminiscent of tuberous sclerosis. Her seizures remained partially controlled with phenytoin and carbamazepine. She presented again 2 years later with an increase in the frequency of her seizures. A magnetic resonance scan of her brain demonstrated a homogenously enhancing mass lesion in her right temporo-parietal lobe. An initial lobectomy showed a hamartomatous lesion on histology but a subsequent sample obtained from a wide resection carried out when there was further worsening of her condition revealed a grade IV astrocytoma within a focal cortical dysplastic lesion. Our case highlights the importance of considering the possibility of a cortical dysplastic lesion harbouring a malignancy and the need for further research to explore the behaviour of these malformative lesions.
Thiryayi
Wasiq Ahmad
WA
Department of Neurosurgery, Leeds General Infirmary, Leeds, UK. waz79@hotmail.com
Donaldson-Hugh
Marcia
M
Ross
Stuart
S
Chakrabarty
Aruna
A
D001927:Brain Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002471:Cell Transformation, Neoplastic; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005909:Glioblastoma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006222:Hamartoma / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D014057:Tomography, X-Ray Computed