Glioblastoma With a Primitive Neuronal Component: A Case Report and Review of the Literature

Glioblastoma (GBM) with a primitive neuronal component (PNC) is an uncommon GBM subtype. We report a rare case of GBM with PNC originating in the left frontal lobe and review the relevant literature. A 60-year-old woman with no previous medical history presented with a generalized seizure. MRI revealed a lesion with ring enhancement in the left frontal lobe, suggestive of a high-grade glioma. The patient underwent gross total tumor resection. Intraoperative pathological examination suggested a high-grade glioma; therefore, photodynamic therapy was applied to the resection cavity. Histopathological examination revealed an isocitrate dehydrogenase-wild-type GBM with PNC. The patient received chemoradiation therapy with temozolomide following the Stupp protocol. However, the tumor recurred rapidly within five months after resection, and bevacizumab was initiated. The tumor decreased in size after bevacizumab administration, and no distant metastasis was confirmed on whole-body CT for at least 25 months. GBM with PNC is a newly recognized and rare GBM subtype characterized by early onset, poor prognosis, and a higher propensity for extracranial metastasis and CSF dissemination compared with conventional GBM.