case_images: PMC10864134_01
case_images: Patient brain neuroimaging. A: Pedigree showing affected and unaffected members of the patient's family. B-G: MRI showing two lesions. The lesions are hyperintense on axial T2-weighted images (B and E) and ring-enhancing on contrast-enhanced T1-weighted images (C and F). Postoperative contrast-enhanced T1-weighted image shows subtotal resection (white arrow) (D and G).
case_images: btrt-12-70-g001.jpg
case_images: PMC10864134_01_btrt-12-70-g001.jpg
case_images: F1
case_images: The patient was treated for rectal cancer at the age of 29 years (Fig. 1A). MRI revealed two ring-enhancing lesions with peritumoral edema at the same site (Fig. 1B, C, E, and F). The patient underwent subtotal surgical resection of the tumor with awake craniotomy (Fig. 1D and G).
case_images: Histopathological findings showing glioblastoma feature, including poorly differentiated pleomorphic tumor cells with marked nuclear atypia and brisk mitotic activity, focal necrosis with pseudopalisades, and microvascular proliferation. The tumor cells were negative for isocitrate dehydrogenase (IDH)-1. P53 staining showed strong positivity in about 30% of the tumor cells. The lesion was diagnosed as glioblastoma, IDH wild type (A and B: H&E staining, x100; C: IDH, x200; D: p53, x200).
case_images: btrt-12-70-g002.jpg
case_images: PMC10864134_01_btrt-12-70-g002.jpg
case_images: F2
case_images: Histopathological analysis showed focal necrosis with pseudo palisades and microvascular proliferation, along with an MIB-1 proliferation index of 70%, leading to a diagnosis of isocitrate dehydrogenase (IDH) wild-type glioblastoma (Fig. 2).