CASE STUDY

A Rare Case of Long-Term Survival in Glioblastoma 

Abstract

This case is about a 38 year old male who was diagnosed with glioblastoma multiform (GBM), which is one of the most aggressive type of brain tumour. Despite of poor prognosis the patient was able to survive five year post diagnosis. This case highlights the role of complete tumour resection, delayed radiotherapy and follow-up treatments in prolonged survival.

Introduction

Glioblastoma is the most common and aggressive malignant brain tumour with a median survival of 12 to 15 months with standard treatments like radiotherapy, surgery and chemotherapy (Telmozolomide). However in certain rare cases patient might have prolonged survival.

Case Presentation

Patient information

• Age & Gender: 38-year-old male

• Symptoms: Severe headaches, nausea

• Medical History: No prior neurological issues

Diagnosis

• Imaging: CT scan showed a 5 cm tumor in the right temporal lobe with edema and ventricular compression.

• Histopathology: Confirmed GBM (WHO Grade IV) post-surgery.

Treatment plan

1.        Surgery: The patient underwent a total tumor resection via craniotomy.

2.        Delayed Radiotherapy: Post-surgical radiotherapy was postponed due to lung testing.

3.        Tumor-Free Period: The patient remained tumor-free for 37 months post-surgery.

4.        Recurrence & Second Surgery:

o   The tumor recurred in the same location.

o   A second craniotomy was performed, followed by radiotherapy (60 Gy/30 fractions).

o   The patient refused chemotherapy.

5.        Final Treatment & Outcome:

o   Further tumor recurrence was detected in 2010.

o   Stereotactic radiotherapy was applied, but tumor progression led to multi-organ failure.

o   The patient passed away after five years of survival, which is rare for GBM.

Discussion

• Removal of the tumour by surgery played an important role in prolonged survival.

• The case challenges the strict timeline for radiotherapy post-surgery.

• Even though chemotherapy wasn’t used it did not affect the prolonged survival of the patient which suggested that the response to treatment can vary from patient to patient.

• It indicates the significance of monitoring the progress of treatment and health of patient frequently and it also shows the importance of multi-modal treatment approaches.

Conclusion

This case underscores the importance of aggressive surgical intervention and personalized treatment strategies in rare, long-term glioblastoma survival. Further research is needed to identify factors influencing extended survival in GBM patients.