Shane Eaton1, Phedias Diamandis1,2, Andrew F. Gao1,2
1Dept. of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
2Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
A 19-year-old woman presented with a 6-month history of headache. Neuroimaging revealed a strongly enhancing intra-axial mass in the right temporal lobe measuring approximately 5cm in maximal dimension. The patient underwent gross total resection at an external institution and was referred to our institution to receive adjuvant chemoradiotherapy.
Approximately 9 months later, the patient was found to have progressive disease and despite re-resection, developed local recurrence and leptomeningeal dissemination to the cervical spine shortly thereafter. She received palliative radiotherapy to the areas of residual disease.
Five months following this, there was evidence of leptomeningeal dissemination throughout the spinal canal and a very large tumour mass in the prior surgical bed associated with significant mass effect. The patient underwent resection of this mass.
- Differential diagnosis and workup?