Snapshot A 47-year-old man presents to the emergency department complaining of a headache. His symptoms have been progressively worsening over the course of week. He does not have a past medical history of headaches and has noticed some weakness in his left upper extremity. Physical examination is notable for 4/5 power throughout the left upper extremity. MRI brain with gadolinium demonstrates a white matter mass lesion with patchy enhancement. Neurosurgery is consulted for surgical resection. Introduction Definition malignant tumor arise from oligodendrocytes most commonly affects the frontal and temporal lobe and is slow growing ETIOLOGY Pathophysiology genetic mutations lead to dysregulated and abnormal cellular proliferation Epidemiology Demographics typically 25-45 years of age Presentation Symptoms/physical exam clinical manifestations depend on where the tumor arises from seizure headaches personality changes Imaging MRI brain with and without contrast indication imaging study of choice findings enhancing mass login to view 2 more bullets Studies Histopathology and molecular testing indication confirms the diagnosis findings histopathology login to view 2 more bullets molecular testing login to view 1 more bullet Differential Other malignant brain neoplasm differentiating factors based on histological findings login to view 1 more bullet Treatment Surgical resection indication login to view 3 more bullets Complications Seizures Neurological deficits Prognosis Poor