Glioblastoma Multiforme – Ring Enhancing Lesion Differential Diagnosis

History: 55 year old male with new onset seizures.

Glioblastoma Multiforme: Axial T1W Post-contrast MR image with fat saturation reveals a heterogeneously enhancing mass within the right temporal lobe with central necrosis. A solid enhancing component is seen extending medially.

This case is a nice example of a ring enhancing mass in the brain. The typical mnemonic used for a solitary ring enhancing mass in the brain is MAGIC-DR which stands for Metastases, Abscess, Glioblastoma Multiforme, Infarct, Contusion, Demyelinating disease (tumefactive multiple sclerosis), and Radiation Necrosis and Resolving hematoma.

The final diagnosis after surgery in this patient was Glioblastoma Multiforme, a rapidly enlarging malignant astrocytic tumor characterized by necrosis and neovascularity. Typically these occur in patients 45-75 years old, and comprise about 10-15% of all intracranial neoplasms. They present with seizures and focal neurological symptoms, and the prognosis is poor, with death commonly occurring within 9-12 months.