case_images: PMC8202363_01
case_images: T1-weighted magnetic resonance imaging image showing a well-defined hypodense lesion in the left parietal lobe with rim enhancement, disproportionate perilesional edema, and midline shift of 8 mm
case_images: AJNS-16-178-g001.jpg
case_images: PMC8202363_01_AJNS-16-178-g001.jpg
case_images: F1
case_images: Disproportionate perilesional edema was seen extending into splenium and causing mass effect in the form of effacement of lateral ventricle, subfalcine herniation, and midline shift of 8 mm towards the opposite side [Figure 1].
case_images: (a) Markedly cellular tumor with areas of infarctoid necrosis (HE, x100). (b) Areas of palisading necrosis surrounded by microvascular proliferation (HE, x400). (c) Microvascular proliferation (HE, x400). (d and e) Cellular tumor with cells showing marked pleomorphism and mitosis. Multinucleate and bizarre cells seen against a fibrillary background (HE, x400). (f) Tumor is positive for glial fibrillary acid protein immunohistochemistry (x400)
case_images: AJNS-16-178-g002.jpg
case_images: PMC8202363_01_AJNS-16-178-g002.jpg
case_images: F2
case_images: Many atypical mitotic figures, areas of palisaded and nonpalisaded necrosis along with microvascular proliferation were seen [Figure 2a-e]. On immunohistochemistry (IHC), the tumor cells were positive for glial fibrillary acid protein (GFAP) [Figure 2f] and negative for Leucocyte Common Antigen (LCA).