MRI of the brain at four timepoints. Each row resembles one examination with coronal acquisition of Flair (or T2, d), coronal contrast enhanced T1 and axial T2 (or Flair,l). After the first MRI in 2006 (a,e,i), showing a non-enhancing tumor, the patient underwent surgery and Astrocytoma WHO II° was diagnosed. In 2008, recurrent tumor (b,f,j) with striking contrast enhancement (f), correlating with histologically proven malignisation to Glioblastoma WHO IV°, was proven by MRI. Again tumor recurrence with rim enhancing tumor (c, g, k), was documented in 04/2011 and surgery was performed. In 08/2011 (d,h,l) MRI of the brain showed that the local contrast enhancing tumor was under control and not responsible for the deteriorating neurological status.