Management of persistent residual growth of high-grade glioma: a case report highlighting clinical and therapeutic challenges

TL;DR

A patient with a history of glioblastoma presented with a recurrence five years after surgery, highlighting the challenges in managing this aggressive brain tumor.

Contribution

This case report emphasizes the importance of personalized, multidisciplinary approaches in managing recurrent glioblastoma.

Findings

The patient presented with a recurrent glioblastoma five years after initial subtotal resection.

Multimodal imaging and individualized treatment strategies are critical for managing recurrent GBMs.

Persistent symptoms and limited treatment options underscore the challenges in managing this disease.

Abstract

Gliomas, particularly glioblastomas (GBMs), are the most common malignant primary brain tumors, comprising nearly 80% of CNS malignancies. Despite aggressive treatment, recurrence is common due to its infiltrative nature and therapy resistance, with median survival around 14–15 months.

A 48-year-old male with a history of WHO Grade IV glioblastoma presented five years after subtotal resection with recurrent symptoms. He had not received adjuvant radiotherapy and was lost to follow-up. Recent imaging showed a lesion near the original tumor site. He underwent repeat craniotomy with subtotal excision. The patient’s neurological status remained stable postoperatively, although headaches persisted.

Recurrent GBMs pose significant management challenges due to diagnostic complexity and limited treatment options. Multimodal imaging and individualized strategies, including surgery and potential adjuvant therapies, are critical.

This case underscores the need for vigilant follow-up and a personalized, multidisciplinary approach to improve outcomes in patients with recurrent glioblastoma.

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