Twenty Years After Glioblastoma Multiforme Diagnosis: A Case of Long-Term Survival

Abstract

Glioblastoma multiforme (GBM) is an aggressive tumor that has a poor prognosis with a median survival of 15 months with treatment and 3-4 months without treatment. Subsets of patients are found to survive longer than two years, some survivors lived more than 10 years, and rare cases survived 20 years or more with treatment. Better prognosis has been found to be associated with many factors. Some of these factors are related to patients' characteristics, biological factors that impact tumor aggressiveness, and/or factors associated with treatment. However, the exact contribution for extended survival is still not known. Finding the factors that have a strong impact on the long survival is of high importance and can help give hope to better treat glioblastoma cases. In this report, we present a case of a glioblastoma patient who was diagnosed at the age of 47 years with more than 20-year survival. We further discuss the suggested factors that may have contributed to a better prognosis with a focus on the possible role of varicella-zoster infection in mediating long-term survival.

Keywords: glioblastoma multiforme; immune surveillance; long term survival; oncolytic viruses; varicella zoster virus.

Figure 1. Pre- and Post-Contrast Brain MRI

Brain MRI was done for the patient in a follow-up visit after 20 years of the GBM tumor resection. Encephalomalacia is seen in the right frontotemporal lobe. No evidence of glioblastoma recurrence. A: axial flair T1, B: axial T2, C and D: post-contrast axial T1.