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Low-grade glioma — SCE Neurology MCQ

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EasyNeuro-oncologyLow-grade gliomaSCE Neurology

A 22-year-old woman presented with new focal seizures in a young adult with subtle language difficulty. On examination, examination showed mild anomia without raised pressure signs. Initial investigations showed: MRI showed non-enhancing T2-hyperintense insular lesion. What is the most likely diagnosis?

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Correct answer: E — Low-grade glioma

Low-grade glioma is the best answer because the vignette describes Low-grade glioma: seizure with non-enhancing infiltrative lesion in young adult suggests low-grade glioma. Brain metastases is plausible in a neighbouring presentation, but the chronology, examination or investigation pattern does not match the key discriminator here. Leptomeningeal carcinomatosis and Spinal cord compression from metastasis are less appropriate because they would require different localisation, timing or test findings; Meningioma would fit a different syndrome. Clinical pearl: cavernoma has haemosiderin rim and popcorn appearance.

Reference: NICE NG99; EANO guidance; ABN paraneoplastic guidance