Twenty-year survival in glioblastoma: a case report and molecular profile.
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.
Sperduto
Christina Maria
CM
Minneapolis Radiation Oncology, Minneapolis, MN, USA. psperduto@mropa.com
Chakravarti
Arnab
A
Aldape
Ken
K
Burger
Peter
P
Papermaster
Gail Bender
GB
Sperduto
Paul
P