Open AccessCase Report
Fast Evolving Glioblastoma in a Pregnant Woman: Diagnostic and Therapeutic Challenges
by
Ivan Bogdanovic, Rosanda Ilic, Aleksandar Kostic, Aleksandar Miljkovic, Filip Milisavljevic, Marija M. Janjic, Ivana M. Bjelobaba, Danijela Savic and Vladimir Bascarevic
Diagnostics 2025, 15(15), 1836; https://doi.org/10.3390/diagnostics15151836 (registering DOI) - 22 Jul 2025
Abstract
Background and Clinical Significance: Gliomas diagnosed during pregnancy are rare, and there are no established guidelines for their management. Effective treatment requires a multidisciplinary approach to balance maternal health and pregnancy preservation.
Case Presentation: We here present a case of rapidly progressing glioma
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Background and Clinical Significance: Gliomas diagnosed during pregnancy are rare, and there are no established guidelines for their management. Effective treatment requires a multidisciplinary approach to balance maternal health and pregnancy preservation.
Case Presentation: We here present a case of rapidly progressing glioma in a 33-year-old pregnant woman. The patient initially presented with a generalized tonic–clonic seizure at 21 weeks’ gestation. Imaging revealed a tumor in the right cerebral lobe, involving both cortical and subcortical structures, while magnetic resonance spectroscopy suggested a low-grade glioma. The patient remained clinically stable for two months but then developed severe headaches; MRI showed a worsening mass effect. At 34 weeks’ gestation, an emergency and premature caesarean section was performed under general anesthesia. The patient then underwent a craniotomy for maximal tumor resection, which was histologically and molecularly diagnosed as IDH wild-type glioblastoma (GB). Using qPCR, we found that the GB tissue showed upregulated expression of genes involved in cell structure (
GFAP,
VIM) and immune response (
SSP1,
TSPO), as well as increased expression of genes related to potential hormone response (
AR,
CYP19A1,
ESR1,
GPER1). After surgery, the patient showed resistance to Stupp protocol therapy, which was substituted with lomustine and bevacizumab combination therapy.
Conclusions: This case illustrates that glioma may progress rapidly during pregnancy, but a favorable obstetric outcome is achievable. Management of similar cases should respect both the need for timely treatment and the patient’s informed decision.
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