Glioblastoma mimicking a cerebral cavernous malformation: case report

Glioblastoma is the most common malignant tumor of the central nervous system, and its diagnosis is typically straightforward based on clinical and neuroimaging data. However, when glioblastoma and cavernous hemangioma exhibit overlapping MRI features, the diagnosis becomes challenging, warranting significant attention from clinicians. In this report, we describe a patient presenting with relatively typical clinical symptoms and magnetic resonance imaging (MRI) findings suggestive of a cerebral cavernous malformation (a circular mass in the left frontoparietal lobe, with mixed signals on T1- and T2-weighted images, heterogeneous enhancement on contrast-enhanced T1-weighted images, and significant hypointensity on susceptibility-weighted imaging). However, intraoperative exploration revealed a solid tumor with hemorrhage, and the final pathological diagnosis was glioblastoma. This misdiagnosed case highlights that clinicians should not rely solely on imaging features suggestive of benign lesions. Even when imaging favors a benign tumor, the possibility of malignancy should be strongly considered in cases presenting with severe perilesional edema and lesion enhancement. Timely surgical exploration and pathological confirmation are crucial to avoid misdiagnosis and ensure appropriate clinical management, thereby improving patient prognosis.