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Glioblastoma — SCE Neurology MCQ

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ModerateNeuro-oncologyGlioblastomaSCE Neurology

A 63-year-old woman presented with new seizures and progressive personality change in an older adult. On examination, there was left-sided neglect and papilloedema. Initial investigations showed: MRI showed irregular ring-enhancing right frontal mass crossing the corpus callosum. What is the most likely diagnosis?

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Correct answer: B — Glioblastoma

Glioblastoma is the best answer because the vignette describes Glioblastoma: rapidly progressive irregular enhancing infiltrative mass suggests glioblastoma. Raised intracranial pressure from tumour is plausible in a neighbouring presentation, but the chronology, examination or investigation pattern does not match the key discriminator here. Spinal cord compression from metastasis and Meningioma are less appropriate because they would require different localisation, timing or test findings; Limbic encephalitis from small-cell lung cancer would fit a different syndrome. Clinical pearl: abscess may ring enhance but usually has restricted diffusion and infection source.

Reference: NICE NG99; EANO guidance; ABN paraneoplastic guidance