title: Epithelioid glioblastoma presenting as massive intracerebral hemorrhage: Case report and review of the literature.
abstract: BACKGROUND
  Glioblastoma multiforme (GBM) is a malignant transformation of glial tissue, which presents as intradural, intraaxial lesions with heterogenous contrast enhancement and mass effect. Intratumoral hemorrhage is a common finding in GBM although it is frequently asymptomatic. Massive, symptomatic, intratumoral hemorrhage is uncommon and poses a diagnostic challenge.
  
  
  METHODS
  Here we discuss a case of GBM, which initially presented as massive, symptomatic intracerebral hemorrhage with underlying mass. Due to size of the hemorrhage and poor neurological status the patient was taken to the operating room for evacuation of this hematoma. On pathology, the mass was found to be epithelioid glioblastoma.
  
  
  CONCLUSIONS
  Identification and diagnosis of GBM is generally straightforward. In certain circumstances, the presentation of GBM can vary from the routine. The above case demonstrates how pitfalls in diagnosis can be avoided in order to initiate appropriate therapy.
authors.affiliation: Department of Neurological Surgery, Houston Methodist Neurological Institute, Houston, TX, USA.
authors.forename: Brandon D
authors.initials: BD
authors.lastname: Liebelt
authors.affiliation: Department of Neurological Surgery, Houston Methodist Neurological Institute, Houston, TX, USA.
authors.forename: Zain
authors.initials: Z
authors.lastname: Boghani
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Takei
authors.affiliation: Department of Radiology, Houston Methodist Neurological Institute, Houston, TX, USA.
authors.forename: Steve H
authors.initials: SH
authors.lastname: Fung
authors.affiliation: Department of Neurological Surgery, Houston Methodist Neurological Institute, Houston, TX, USA.
authors.forename: Gavin W
authors.initials: GW
authors.lastname: Britz
keywords: Epithelioid; glioblastoma; intratumoral hemorrhage