Glioma - pre and post-contrast CT

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Glioma - pre and post-contrast CT

  • A 'space-occupying' mass lesion in the left cerebral hemisphere shows 'ring-enhancement' post intravenous contrast
  • Centrally the mass is low in density due to necrosis of brain tissue
  • Biopsy confirmed this to be a glioma (malignant brain tumour)
  • Cerebral abscesses can look identical and so should be considered as a differential diagnosis of a ring-enhancing lesion

Clinical information

  • Headache worsening for 2 weeks
  • Irritability
  • Increased tone in right arm
  • Afebrile with normal inflammatory markers

Cerebral abscess - pre and post-contrast CT

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Cerebral abscess - pre and post-contrast CT

  • The post-contrast CT image shows a ring enhancing lesion in the right frontal lobe with oedema of surrounding white matter
  • It is not possible to reliably distinguish a brain tumour from a cerebral abscess on the grounds of CT appearances alone
  • Clinical and biochemical features can help to determine the cause of a ring enhancing lesion
  • MRI can also be helpful

Clinical information

  • 2 day history of increasing headaches and clumsiness
  • Seizure
  • In this case the inflammatory markers were normal and a tumour was initially suspected
  • Tissue biopsy confirmed this to be an abscess