ASTROCYTOMA (POST SURGICAL SPECIMEN)
This 49 year old man originally presented with a 6 month history of abdominal pain and personality changes. It was also noticed about that time that he was stumbling and becoming vague mentally. Examination revealed a drowsy man with a left facial weakness and slow slurred speech. Tone seemed to be increased bilaterally, more on the left. There was an equivocal field defect in the left temporal area. Right carotid angiography suggested a right parietal space occupying lesion. Craniotomy was performed but only a biopsy was taken. Patient deteriorated and died 2 weeks post-operatively.
The specimen is of a brain sliced coronally to show the region of the basal ganglia. (On the right there is a haemorrhagic surgical lesion extending from cortex to basal ganglia and packed with Gelfoam). The right hemisphere is enlarged in the parietal region, there being some gyral flattening. There is an extensive greyish tumour bulging into the right lateral ventricle. The tumour appears to be arising from the ventricular wall and to be invading the septum pellucidum with extension into the third ventricle. The tumour is not encapsulated, is poorly defined and is invading both white and grey matter. At necropsy, small tumour seedings on the walls of both lateral ventricles were evident. Histologically the tumour was an astocytoma.