The Significance of Lack of MR Contrast Enhancement of Supratentorial Brain Tumors in Adults: Histopathological Evaluation of a Series

Surg Neurol. 1998 Apr;49(4):436-40. doi: 10.1016/s0090-3019(97)00360-1.

Abstract

Background: To correlate magnetic resonance imaging (MRI) findings of non-enhancement of supratentorial brain neoplasms in adults with histopathologic findings.

Methods: Forty adult patients whose preoperative MRI studies demonstrated a non-enhancing supratentorial brain neoplasm were identified retrospectively. Biopsy material for all patients was then reviewed by a board-certified neuropathologist.

Results: Histopathologic examination identified 24 (60%) low-grade gliomas: 4 (10%) low-grade astrocytomas, 10 (25%) low-grade gliomas (not further classified), 8 (20%) low-grade oligodendrogliomas, and 2 (5%) low-grade mixed oligoastrocytomas. However, 16 (40%) nonenhancing lesions were classified as anaplastic gliomas: 12 (30%) anaplastic astrocytomas, 1 (2.5%) anaplastic mixed oligoastrocytoma, 1 (2.5%) anaplastic oligodendroglioma, and 2 (5%) anaplastic infiltrating gliomas of indeterminate subtype.

Conclusion: Non-enhancement of supratentorial brain neoplasms in adults does not equate with low-grade malignancy. This fact should be taken into account when biopsy and treatment are being planned in patients with nonenhancing brain tumors. More aggressive and/or surgical therapy might be indicated for such lesions, particularly those in the nondominant hemisphere or nonmotor areas.

MeSH terms

  • Adult
  • Aged
  • Female
  • Glioma / pathology*
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Supratentorial Neoplasms / pathology*