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Oligodendrogliomas are common intra-axial primary brain tumours, and carry special significance due to several key features, which when present provide better prognosis compared to other intra-axial tumours.
A brain computed tomography (CT) scan revealed a left frontal intra-axial thick-walled ring-enhancing lesion with extensive surrounding edema, possibly a high-grade neoplastic lesion (glioma) involving the corpus callosum, or a contiguous inflammatory or infectious process originating from the skull base.
If intra-axial, a vascular malformation should be considered.
Magnetic resonance imaging (MRI) of the brain demonstrated a mixed cystic and solid, heterogeneously enhancing intra-axial mass centered within the left frontal lobe effacing the adjacent frontal horn of the lateral ventricle (Figure 1).
Axial MR images demonstrate a T1 hypointense, T2 FLAIR hyperintense mass-like intra-axial confluence centered within the right posterior frontal lobe and right superior parietal lobule with surrounding mass effect and minimal resulting right to left midline shift (Figures 2 and 3).
Angiographic anatomy demonstrated a purely intra-axial mass.
GS typically appear as rapidly growing, heterogeneously enhancing intra-axial masses comparable to GB with a temporal predominance [4, 6].
On the 11th postoperative day, the cerebral CT was repeated and showed the extended left tempo--parietal craniotomy, the inhomogeneous hypodense mass with edema and intra-axial dilacerations at the level of the left cerebral hemisphere with a protrusion through the craniotomy orifice.
They rarely present hemorrhage as a clinical manifestation, in contrast to intra-axial hemangiomas that show a bleeding incidence of 25% (15,26).
This technique produces greater discrimination of high-signal intra-axial lesions adjacent to CSF or at brain-CSF interfaces.
Noncontrast brain CT scan revealed an intra-axial lesion centered in the right thalamic region measuring 3.5 cm in maximal diameter with associated midline shift and downward herniation, most likely representing an abscess.
Axial T1WI (A), axial T2WI (B) and axial FLAIR (C) images show a well-defined intra-axial cystic lesion with eccentric soft tissue mural nodule in right frontoparietal lobe.
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