Malignant brain tumour with challenging intraoperative findings

Gabriele Gaggero; Silvia Bozzano; Nicoletta Fasano; Michele D’Agruma; Valerio GaetanoVellone; Giulio Fraternali Orcioni

doi:10.5114/pjp.2025.153979

eISSN: 2084-9869
ISSN: 1233-9687

Polish Journal of Pathology

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2/2025
vol. 76

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abstract:

Case report

Malignant brain tumour with challenging intraoperative findings

Gabriele Gaggero

¹

,

Silvia Bozzano

²

,

Nicoletta Fasano

³

,

Michele D’Agruma

⁴

,

Valerio GaetanoVellone

¹

,

Giulio Fraternali Orcioni

⁵

Pathology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
Department of Integrated Surgical and Diagnostic Sciences, Division of Anatomical Pathology, Scuola di Scienze Mediche e Farmaceutiche, Universita di Genova, Genoa, Italy
SSD Neuroradiologia, A.O. Santa Croce e Carle, Cuneo, Italy
SC Neurochirurgia, A.O. Santa Croce e Carle, Cuneo, Italy
SC Anatomia Patologica, A.O. Santa Croce e Carle, Cuneo, Italy

Pol J Pathol 2025; 76 (2): 168-172

DOI: https://doi.org/10.5114/pjp.2025.153979

Online publish date: 2025/09/22

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This case report describes a rare and challenging glioblastoma variant with a biphasic morphology comprising both giant cell and primitive neuronal components. The tumour exhibited aggressive features and was difficult to diagnose during the intraoperative evaluation due to the predominance of small blue cell morphology, which complicated differentiation from haematological and metastatic lesions. Immunohistochemistry and molecular profiling confirmed a glioblastoma, IDH-wildtype, with combined giant cell and primitive neuronal features, and the p53 mutation in both components is a novel finding with potential implications for diagnosis and treatment. This report emphasises the importance of recognising morphological diversity in glioblastoma to avoid misdiagnosis and enable appropriate clinical management.

keywords:

Malignant brain tumour with challenging intraoperative findings

Gabriele Gaggero 1 , Silvia Bozzano 2 , Nicoletta Fasano 3 , Michele D’Agruma 4 , Valerio GaetanoVellone 1 , Giulio Fraternali Orcioni 5

glioblastoma, giant cell, primitive neuronal tumour, IDH wildtype

Gabriele Gaggero

¹

,

Silvia Bozzano

²

,

Nicoletta Fasano

³

,

Michele D’Agruma

⁴

,

Valerio GaetanoVellone

¹

,

Giulio Fraternali Orcioni

⁵