Clinical characteristics and prognostic analysis of calcified glioblastoma

Glioblastoma (GBM) is a common malignant intracranial tumor. There are a few clinical studies focusing on GBM with calcification. Based on diagnosed cases from our cohort and related literature reports, we investigate its clinical characteristics and diagnosis-treatment strategies.

A retrospective analysis was conducted on the clinical data of 4 patients with pathologically confirmed GBM with calcification admitted between 2017 and 2023. In addition, 5 cases with complete clinical data were identified through a literature review, yielding a total of 9 cases. Based on these cases, we analyzed and discussed the clinical features, treatment strategies, and prognostic outcomes of GBM with calcification in combination with the published literature.

A total of 9 cases of GBM with calcification were included in this study, comprising 4 cases diagnosed in our institution and 5 cases reported in the literature, with an incidence of 0.95%. The median age at diagnosis was 47 years, with a male-to-female ratio of 4:5. Imaging findings were mainly supratentorial lesions, predominantly showing long T1 and long T2 signals, with calcifications appearing as punctate or linear patterns accompanied by significant peritumoral edema, necrosis, and cystic changes. Histologically, all cases demonstrated typical GBM features, with calcification observed in some specimens. Immunophenotypically, Ki-67, Olig-2, and P53 showed high positivity rates.

Patients who underwent gross total resection had longer survival times than those who underwent partial resection.

In terms of prognosis, the median postoperative overall survival time of GBM patients with calcification was 91.32 days, significantly shorter than that of general GBM patients in the same period (570 days). These findings suggest that calcification may be a potential indicator of poor prognosis in GBM.

The clinical manifestations of GBM patients with calcification have certain characteristics, and the impact of surgery on these patients is different from that on non-calcified GBM. The timing of surgery needs to be carefully selected.