Brainstem glioblastoma in a neurofibromatosis type 1 patient: A rare but aggressive presentation

Glioblastoma multiforme is a highly aggressive central nervous system tumor, rarely seen in the infratentorial region, particularly in patients with Neurofibromatosis Type 1 (NF1). While NF1 is more commonly associated with low-grade gliomas, the development of high-grade gliomas such as glioblastoma remains uncommon and poses diagnostic and therapeutic challenges. We report a rare case of brainstem glioblastoma IDH-wild type in an adolescent with NF1, initially presenting with nonspecific neurological symptoms. Imaging revealed a lesion in the cerebello-medullary region, and histopathology confirmed glioblastoma IDH-wild type. This case underscores the importance of maintaining a high index of suspicion for malignant transformation in NF1-related central nervous system lesions. Given the rarity and aggressive nature of brainstem glioblastoma IDH-wild type in NF1, timely diagnosis, multidisciplinary management, and vigilant follow-up are essential for optimizing outcomes in this high-risk patient group.