CT with contrast T1 axial post gad T2 axial

Diagnosis: Grade 3 astrocytoma

High grade lesions (3, 4) represent 1/3 of all astrocytomas. Patients often present between the ages of 40 and 60 with seizures, headache or focal neurologic deficit. High grade astrocytomas typically show some enhancement as well as mass effect and vasogenic edema in the surrounding white matter. They may have small foci of hemorrhage; however, large hemorrhages are unusual. Calcification is very uncommon.

The differential for this case is limited given the clinical history and the finding of a non-enhancing mass infiltrating the white matter. A metastasis should enhance. Also, a single metastasis of this size is unusual without other lesions. Infarct is unlikely secondary to the involvement of both the ACA and MCA territories. However, a subacute infarct may have mass effect and enhance. Related Cases

Lung cancer metastases Multiple astrocytomas Glioblastoma