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canp2019c07

Case 7

GA Yeaney

Divisions of Neuropathology and Ocular Pathology, Department of Anatomic Pathology, R.T. Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, US

 

A 20-year-old female presented with two transient somatosensory paroxysmal episodes, which started from either foot and then had possible Jacksonian march to involve upper body as detailed here: She experienced sudden right sided numbness (greater than weakness) that began in her foot and radiated to her shoulder lasting about 20 minutes. Her friend drove her to the local emergency department. During the ride to the hospital her right sided weakness resolved, but she experienced 20 minutes of left arm numbness and left sided visual field disturbance. This resolved once she got to the hospital. There is no relevant family history or past medical history. 

CT and MR imaging of the brain, May 2019, revealed an avidly enhancing multilobulated left-sided intraventricular mass with extension to left cingulate gyrus, septal deviation to the right, and surrounding edema in the left frontal lobe.  The lesion was isointense on DWI. There was no FLAIR change in corpus callosum, just in septum.  She was started on steroids and Keppra.  A gross total resection of tumor was performed.

 

Material Submitted:   

MR axial FLAIR and T1 post-contrast image

H&E virtual slide

 

Questions:                  

1. What is the diagnosis?

2. Can this tumor be classified according to WHO 2016?