A 62-year-old patient with a personal history of chronic glaucoma and hysterectomy. She presented with a picture of loss of fixation memory, of approximately one month's evolution, initially labelled as a symptom of a depressive process. There was no neurological focality on physical examination. His family history is that both his mother and grandmother died of cerebral glioblastoma. The cranial computed tomography (CT) scan shows the presence of a left frontal cortico-subcortical intraaxial cortico-subcortical expansion process; the magnetic resonance imaging (MRI) findings of this lesion are considered compatible with a high-grade glioma, located in the left hemispheric premotor region...

Surgical treatment was initially performed by means of a left frontal craniotomy, with complete resection of the tumour, whose histological report confirmed the diagnosis of glioblastoma multiforme. A control CT scan on the first postoperative day confirmed the absence of tumour remains. Subsequently, he underwent adjuvant treatment with radiotherapy and chemotherapy, according to the usual protocols, with no morbidity derived from either of these treatments.

The patient's evolution was favourable, remaining asymptomatic in successive check-ups. Thirteen months after surgery, a control MRI scan revealed a right frontal cortico-subcortical lesion suggestive of a high-grade glioma, with no apparent connection to the contralateral tumour and no signs of recurrence of the lesion. She was reoperated 14 months after the first surgery by means of a right frontal craniotomy with complete resection of the tumour. The histological report confirmed that it was a glioblastoma. The postoperative control CT scan showed complete resection of the right lesion. An assessment by Oncology ruled out adjuvant radiotherapy and treatment with chemotherapy was decided.

The patient remained asymptomatic. Three months after the second surgery and a control CT scan revealed a small right basal temporal nodule that captured contrast and was suggestive of a new focus of glioblastoma. The patient refused invasive treatment and underwent palliative conservative treatment. Subsequent imaging studies revealed new tumour lesions. The patient died 26 months after the first surgery.

