{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:19:14Z","timestamp":1790036354764,"version":"4.0.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T00:00:00Z","timestamp":1710288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Diffuse pontine glioblastoma multiforme is a rare subtype of glioblastoma associated with a poor prognosis. In this case report, we present a unique case of diffuse primary pontine glioblastoma multiforme in a patient without any supratentorial lesions. We review the symptoms, treatment options, and case management of patients with infratentorial glioblastoma multiforme and compare these with our patient. Our patient presented with symptoms including progressive diplopia, gait disturbance, and lower extremity weakness. Magnetic resonance imaging revealed a diffuse lesion involving the pons and biopsy revealed only mildly-atypical glial infiltrates. Consequentially, diagnosis was driven by genetic analysis. Due to the location of the tumor, surgery was not considered a viable option. Instead, the patient received radiation therapy along with concomitant and adjuvant temozolomide chemotherapy which has resulted in improvement of symptoms. This case highlights the challenges of managing diffuse primary pontine glioblastoma multiforme and the need for more effective treatment options for this rare subtype of glioblastoma. Despite aggressive treatment, the prognosis for patients with infratentorial glioblastoma multiforme remains poor, with a median survival time of less than a year. Further research is needed to improve our understanding of the biology and optimal management of this disease.<\/jats:p>","DOI":"10.3389\/fonc.2024.1279897","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T04:49:07Z","timestamp":1710305347000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Unusual presentation of glioblastoma in the brainstem: a case report of a diffuse pontine glioblastoma multiforme and surgical management"],"prefix":"10.3389","volume":"14","author":[{"given":"Brandon","family":"Edelbach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vadim","family":"Gospodarev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Lopez-Gonzalez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Deisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maninder","family":"Kaur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"469","DOI":"10.3390\/cancers11040469","article-title":"Pathological and molecular features of glioblastoma and its peritumoral tissue","volume":"11","author":"D\u2019Alessio","year":"2019","journal-title":"Cancers (Basel)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.jocn.2017.10.041","article-title":"Patient and treatment factors associated with survival among pediatric glioblastoma patients: A Surveillance, Epidemiology, and End Results study","author":"Lam","year":"2018","journal-title":"J Clin Neurosci"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab200","article-title":"CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2014-2018","volume":"23","author":"Ostrom","year":"2021","journal-title":"Neuro-oncology"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000032042","article-title":"Clinical characteristics and prognosis of patients with glioblastoma: A review of survival analysis of 1674 patients based on SEER database","volume":"101","author":"Chen","year":"2022","journal-title":"Med (Baltimore)"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/75596","article-title":"Combined activation of Ras and Akt in neural progenitors induces glioblastoma formation in mice","volume":"25","author":"Holland","year":"2000","journal-title":"Nat Genet"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S1535-6108(02)00046-6","article-title":"Epidermal growth factor receptor and Ink4a\/Arf: convergent mechanisms governing terminal differentiation and transformation along the neural stem cell to astrocyte axis","volume":"1","author":"Bachoo","year":"2002","journal-title":"Cancer Cell"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-013-1141-6","article-title":"Upregulating mutations in the TERT promoter commonly occur in adult Malignant gliomas and are strongly associated with total 1p19q loss","volume":"126","author":"Arita","year":"2013","journal-title":"Acta Neuropathol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1407279","article-title":"Glioma groups based on 1p\/19q, IDH, and TERT promoter mutations in tumors","volume":"372","author":"Eckel-Passow","year":"2015","journal-title":"N Engl J Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nou294","article-title":"Molecular pathologic diagnosis of epidermal growth factor receptor","author":"Maire","year":"2014","journal-title":"Neuro Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccr.2006.02.019","article-title":"Molecular subclasses of high-grade glioma predict prognosis, delineate a pattern of disease progression, and resemble stages in neurogenesis","volume":"9","author":"Phillips","year":"2006","journal-title":"Cancer Cell"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-12-3002","article-title":"The definition of primary and secondary glioblastoma","volume":"19","author":"Ohgaki","year":"2013","journal-title":"Clin Cancer Res"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.1034794","article-title":"Establishment of a cell senescence related prognostic model for predicting prognosis in glioblastoma","volume":"13","author":"Li","year":"2022","journal-title":"Front Pharmacol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.ccr.2009.12.020","article-title":"An integrated genomic analysis identifies clinically relevant subtypes of glioblastoma characterized by abnormalities in PDGFRA, IDH1, EGFR and NF1","volume":"17","author":"Verhaak","year":"2010","journal-title":"Cancer Cell"},{"key":"B14","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1056\/NEJMoa043331","article-title":"MGMT gene silencing and benefit from temozolomide in glioblastoma","volume":"352","author":"Hegi","year":"2005","journal-title":"N Engl J Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-06-0596","article-title":"Temozolomide-mediated radiation enhancement in glioblastoma: a report on underlying mechanisms","volume":"12","author":"Chakravarti","year":"2006","journal-title":"Clin Cancer Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"171:105780","DOI":"10.1016\/j.phrs.2021.105780","article-title":"Glioblastoma Multiforme (GBM): An overview of current therapies and mechanisms of resistance","author":"Wu","year":"2021","journal-title":"Pharmacol Res"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/nop011","article-title":"Inherited predisposition to glioma","volume":"12","author":"Kyritsis","year":"2010","journal-title":"Neuro Oncol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2010.02.015","article-title":"Glioblastoma of the cerebellum and brainstem","volume":"17","author":"Stark","year":"2010","journal-title":"J Clin Neurosci"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.04.035","article-title":"Outcome and prognostic factors in cerebellar glioblastoma multiforme in adults: a retrospective study from the Rare Cancer Network","volume":"66","author":"Weber","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B20","first-page":"398","article-title":"Infratentorial glioblastoma multiforme: case report and review of literature","volume":"94","author":"Magoha M a.","year":"2017","journal-title":"East Afr Med J"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/(ISSN)1097-0142","article-title":"Extraneural metastases of infratentorial glioblastoma multiforme to the peritoneal cavity","volume":"69","author":"Newton","year":"1992","journal-title":"Cancer"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.33588\/rn.6309.2016208","article-title":"Infratentorial congenital glioblastoma multiforme. A rare tumour with a still unknown biology","volume":"63","author":"Salas","year":"2016","journal-title":"Rev Neurol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurad.2015.10.006","article-title":"Radiological features of cerebellar glioblastoma","volume":"43","author":"Kikuchi","year":"2016","journal-title":"J Neuroradiol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100047454","article-title":"Supratentorial glioblastoma with spinal cord intramedullary metastasis","volume":"20","author":"Hamilton","year":"1993","journal-title":"Can J Neurol Sci"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2024.1279897\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T04:49:09Z","timestamp":1710305349000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2024.1279897\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,13]]},"references-count":24,"alternative-id":["10.3389\/fonc.2024.1279897"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2024.1279897","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,13]]},"article-number":"1279897"}}