title: Twenty-year survival in glioblastoma: a case report and molecular profile.
abstract: BACKGROUND
  The prognosis for patients with glioblastoma (GB) remains grim. Historically, the median survival has been 6 to 9 months. Recent research has improved the outcome slightly. A computer search of the literature reveals few long-term survivors.
  
  
  METHODS
  Presented here is a case report of a 20-year survivor of GB, with pathologic review to confirm the diagnosis. A battery of molecular studies was performed to develop a molecular profile of this unique patient.
  
  
  RESULTS
  The results of the molecular genetic testing for this most unusual patient were as follows: (1) methylguanine methyl transferase (MGMT) was methylated, (2) p53 positive, (3) PTEN tumor suppressor gene positive, (4) protein kinase AKT (pAKT) negative, and (5) epidermal growth factor receptor negative.
  
  
  CONCLUSIONS
  To our knowledge, this is the longest survival of any patient in the literature whose initial diagnosis was GB. Triple-positive GBM patients (MGMT methylated, PTEN, and p53 positive) are uncommon but may be associated with a better prognosis. Further research is needed to confirm whether this molecular profile is prognostic of prolonged survival. Molecular genetics will determine future treatment and prognosis in GB.
authors.affiliation: Minneapolis Radiation Oncology, Minneapolis, MN, USA. psperduto@mropa.com
authors.forename: Christina Maria
authors.initials: CM
authors.lastname: Sperduto
authors.forename: Arnab
authors.initials: A
authors.lastname: Chakravarti
authors.forename: Ken
authors.initials: K
authors.lastname: Aldape
authors.forename: Peter
authors.initials: P
authors.lastname: Burger
authors.forename: Gail Bender
authors.initials: GB
authors.lastname: Papermaster
authors.forename: Paul
authors.initials: P
authors.lastname: Sperduto