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A 42-year-old man presented with progressive change in personality, confusion, and difficulty walking. MRI of the brain showed diffuse high T2 signal throughout the white matter bilaterally, with only focal enhancement. Following a brain biopsy, he received radiation therapy but declined neurologically and died 30 months after initial diagnosis. At autopsy, the deep cerebral white matter was expanded bilaterally and the gray-white junction was indistinct.
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• Anaplastic astrocytoma
• Diffuse fibrillary astrocytoma
• Gliomatosis cerebri
• Radiation necrosis, late-delayed type
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