Early extracranial dissemination with prolonged survival in IDH-wildtype glioblastoma: case study and comprehensive literature review.
Colin Burns, Cheng Chia Wu, Kei Suzuki et al.
✦ AI-curated · Sources linked
Case in brief
A 65-year-old woman with IDH-wildtype, MGMT-methylated glioblastoma presented with seizures, right hemiplegia, and expressive aphasia. After near-total resection and chemoradiotherapy with temozolomide, a suspicious right lower-lobe lesion identified at initial staging and mediastinal lymph-node involvement were confirmed as metastatic glioblastoma within one month of diagnosis. Despite pulmonary and mediastinal disease, intracranial hemorrhage, seizures, and venous thromboembolism, she survived 25 months from diagnosis, including 24 months after metastatic disease was confirmed.
What made this case unusual
The case combined extracranial spread confirmed within one month of the glioblastoma diagnosis with prolonged post-metastatic survival, despite lung and mediastinal involvement.
Diagnostic / clinical pearl
A suspicious extracranial lesion at initial staging may represent glioblastoma metastasis; in this case, mediastinal involvement was biopsy-confirmed within one month of diagnosis.
Why it matters
The authors suggest early extracranial dissemination may be underrecognized and warrants further study using risk-stratified surveillance approaches.