Surgical Approach and Prognosis of Glioblastoma in the Cerebellum: Case Study of an Older Patient

Abstract

Introduction: Glioblastomas are highly aggressive malignant brain tumors and are rarely located in the cerebellum. This case report describes a rare case of cerebellar glioblastoma, contributing to the national literature by addressing the clinical, diagnostic, and therapeutic characteristics of the case. Case report: A 75-year-old woman was admitted to the Hospital Universitário São Francisco de Assis presenting initial symptoms of dizziness and imbalance, with rapid progression over 20 days. Imaging studies, including computed tomography and magnetic resonance imaging, revealed a large solid-cystic lesion in the right cerebellar hemisphere, with necrotic features and intense post-contrast enhancement. The patient underwent total surgical resection of the lesion, achieving good initial recovery and no residual tumor on immediate postoperative imaging. She was monitored at the intensive care unit and discharged on the eighth postoperative day. The histopathological examination, complemented by immunohistochemistry, confirmed the diagnosis of grade 4 glioblastoma IDH-wildtype. The patient was referred for adjuvant treatment with radiotherapy (28 sessions) and chemotherapy (using temozolomide). The patient passed away 14 months after the surgical procedure. Conclusion: This report contributes to the national literature on cerebellar glioblastoma, emphasizing the importance of early diagnosis, total surgical resection, and proper follow-up, while also highlighting the need for regional studies that consider Brazil’s clinical and epidemiological specificities.