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Case of the Month: October 2026

Clinical history

  • 47-year-old right-handed woman​

  • First seizure four years ago​

  • Left frontal lobe mass found the same year​

  • Seizures recently more frequent​

  • MRI now: 5 cm mass with patchy enhancement and new hemorrhage​

  • Awake craniotomy with language mapping, tumour resected​

Preoperative MRI
Preoperative MRI

Large heterogeneous mass in the left frontal lobe​

  • Intra-axial, about 5 cm in each dimension​

  • Patchy enhancement in part of the lesion​

  • New hemorrhage with a fluid-fluid level​

  • FLAIR hyperintensity around the lesion​

  • 2 mm midline shift, no other lesions​

Questions:

  1. What is the differential diagnosis for this mass?​

  2. Which features do you see on H&E?​

  3. What is the diagnosis, and which tests confirm it?​

How to participate

Take a look at the images.

Anyone is welcome to try to solve the puzzle by commenting on the related post on our Instagram.

If you are a medical student at the University of Toronto, you can also:

Join the Special Interest Group in Laboratory Medicine to learn more about Laboratory Medicine.

Laboratory Medicine and the study of disease for medical students

Medical students in the gross lab