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johnthurtjr
[Here's more info](http://www.pathologyoutlines.com/topic/cnstumormeningiomageneral.html)
+2
meningitis
I got it wrong because I didn't see any apparent Dura mater nor other meninges (The veins aren't being covered by any "shiny layer"), so I thought the tumor was coming from inside the brain and not compressing it like meningiomas usually do.
+3
meningitis
But it did follow the common aspect where they are found in between divisions of brain and are circular growths like a ball.
+9
nala_ula
Since it was basically implied that the patient died and "here look at what this is" I thought it was a malignant tumor (glioblastoma)... but I guess it's all about placement.
+15
thelupuswolf
GBM would be in the perenchyma. Devine podcast said if they show you a gross picture of the bottom of the brain then it's a hemangioblastoma bc it's most often cerebellar. But this one wasn't cerebellar so I went ahead with meningioma (FA says external to brain parenchyma as well)
+2
vivijujubebe
GBM would have necrosis and bleeding whereas the ball-shaped tumor in the picture looks smooth and very benign...even tho I have no idea how someone can die so suddenly from meningioma
+1
seba0039
Minor correction, but I do not think that Meningiomas are the most common brain tumor; they are the most common benign brain tumor of adults (Pathoma), but I'm not sure if they're the most common overall.
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an1
This image gave us all the telltales for meningioma: an elderly woman, midline mass, round. I think another thing that made me opt for meningioma was that I had to look for the mass and make sure I wasn't looking at the wrong thing. From what I've seen, GBM presents with a unilateral, hemorrhagic, necrotic mass that would stick our like a sore thumb.
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htballer55
I felt the same way. but if you look at autopsy pics on google, you see the meningioma is like a ball coming out of the meninges.
compare that to glioblastoma which is within the brain in cerebral hemispheres.
so it's mainly one tumor is coming out of the brain and the other is inside the cerebral hemispheres.
that's the best i can come up with. but it's confusing
+5
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masonkingcobra
Above is obviously incorrect because the answer is Meningeal lol.
Here is a link to a good picture:
http://neuropathology-web.org/chapter7/chapter7fMiscellaneous.html
+28
kernicterusthefrog
Obviously thomas is disagreeing with the presentation of the question, and I agreed with him! This absolutely sounds like GBM, with rapid onset leading to death, and the symptoms. The question stem leads you to GBM, and the gross image to meningioma (I guess).
+2
kernicterusthefrog
Furthermore, where are the meninges on the gross image form which this (meningioma) grew?! It should at least show the tissue from whence it came!
+1
nala_ula
Had the same problem, got confused since it appeared that the growth was malignant :(
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sugaplum
FA 2019 pg 514, also agree with everyone. weird presentation. Glios are malignant death within 1 year, meningioma are often asymptomatic or have focal signs.
just a gross pathology question at this point
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garima
ฤฑ think she died bc of pressure or something guys, its obviously round shaped benign lesion, its also extra axial not like GBM. she had this maybe years before death
+2
skonys
I think the point is that GBM causes a rapid decline and death at relatively small lesion size because it's within the parenchyma. Meningiomas are benign and can grow insanely large before they cause symptoms.
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-
Astrocytes proliferate to form glial tumors in adults, for example, glioblastoma. These highly malignant tumors appear as intra-axial masses in the cerebral hemispheres, which typically demonstrate areas of necrosis and can spread to the opposite
hemisphere across the corpus callosum.
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Meningiomas are the most common primary brain tumors in adults. Malignant meningiomas may grow rapidly and cause symptoms of increased intracranial pressure such as headache. Meningiomas appear as well-circumscribed, extraaxial
masses that compress the adjacent brain parenchyma.***Parasaggital regions.
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submitted by โjohnthurtjr(168)
I'm not a fan of gross path images and questions that say "look, what is this thing?" - that said meningiomas are the most common brain tumor and this picture is is a good example of one. I had no idea what these things looked like and got it wrong, too. Take a look at this one