Malignant brain tumour with challenging intraoperative findings.

Abstract

This case report describes a rare and challenging glioblastoma variant with a bi-phasic 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. Im-munohistochemistry and molecular profiling confirmed a glioblastoma, IDH-wild-type, with combined giant cell and primitive neuronal features, and the p53 muta-tion in both components is a novel finding with potential implications for diagnosis and treatment. This report emphasises the importance of recognising morpholog-ical diversity in glioblastoma to avoid misdiagnosis and enable appropriate clinical management.