Butterfly glioma

The ‘butterfly glioma’ refers to a high grade astrocytoma, usually a GBM, which crosses the midline via the corpus callosum. Most frequently this occurs in the frontal lobes, but posterior butterflies are also encountered. The differential is narrow, essentially between a GBM and primary cerebral lymphoma. Demyelination has a predeliction for the corpus callosum and when it is tumefactive may have similar appearances.
Occasionally a leptomeningeal process which fills the quadrigeminal and ambient cisterns can cause confusion.
Like all high grade gliomas the prognosis is dismal, and usually no attempt at ‘curative’ (whatever that means for a GBM) resection is made.
For more images of this patient, and a picture of a butterfly please visit Radiopaedia.org here.
References:
1. StatDx.com, Amirsys
2. Dähnert W. Radiology Review Manual 5th edition. Lippincott, Williams & Wilkins 2003
Credit: Dr Frank Gaillard
http://www.radpod.org