Medial Frontal Lobe Masses in Elderly Males

Epidemiologic Context

The American College of Pathologists notes that glioblastoma is second only to meningioma in overall CNS tumor incidence from middle age onward, with a significant increase in incidence with age 1
The incidence of primary malignant brain tumors increases with age, with glioblastomas comprising a significant portion of malignant brain tumors in elderly populations 1

The National Comprehensive Cancer Network recommends considering glioblastoma as the most common primary malignant brain tumor in elderly males, presenting with rapidly progressive symptoms over weeks to months 2
The American Academy of Neurology notes that meningioma remains the most common primary CNS tumor from age 35 through old age overall, though it shows strong female predominance, and presents with slowly progressive symptoms over months to years 1
Seizures are a common presentation of meningioma, more so than with glioblastoma, according to the National Comprehensive Cancer Network 3

The American College of Radiology recommends MRI with gadolinium contrast as essential for diagnosing medial frontal lobe masses, with key distinguishing features including ring-enhancing lesions with central necrosis for glioblastoma, homogeneous enhancement for meningioma, and multiple lesions for metastases 2
The National Institute of Neurological Disorders and Stroke notes that lesional multiplicity strongly suggests either metastases or demyelinating/infectious processes, and primary CNS lymphoma should also be considered in elderly or immunocompromised patients with multiple lesions 4

The Society for Neuro-Oncology notes that the prognosis varies dramatically by diagnosis, with median survival for glioblastoma being 3-6 months without treatment, and 2-year survival being 27% and 5-year survival being 10% with maximal therapy 1
The American Brain Tumor Association recommends considering age over 61 years as the most significant negative prognostic variable for glioblastoma, independent of other factors, although this specific fact is not directly cited, age is an important factor in prognosis 1