BACKGROUND: We report the case of a man with glioblastoma containing a component radiologically and histologically mimicking adipose tissue.

CASE DESCRIPTION: A 48-year-old man recently complaining of headaches and difficulty with speech presented with a cystic peripherally enhancing left temporoparietal mass with focal intrinsically (precontrast) bright nodules in fluid attenuated inversion recovery and T1-weighted images similar to adipose tissue. Histologically, the enhancing component was classic glioblastoma, whereas the bright nodules comprised tumor cells that in aggregate closely resembled adipose tissue.

CONCLUSIONS: The case illustrates the extent to which lipidized central nervous system tumors of glial origin, or components thereof, can radiologically and histologically resemble adipose tissue. However, immunohistochemical staining and electron microscopy can eliminate diagnostic confusion.