Management of persistent residual growth of high-grade glioma: a case report highlighting clinical and therapeutic challenges.

Introduction: Gliomas, particularly glioblastomas (GBMs), are the most common malignant primary brain tumors, comprising nearly 80% of CNS malignancies. Despite aggressive treatment, recurrence is common due to its infiltrative nature and therapy resistance, with median survival around 14-15 months. Case Presentation: A 48-year-old male with a history of WHO Grade IV glioblastoma presented five years after subtotal resection with recurrent symptoms. He had not received adjuvant radiotherapy and was lost to follow-up. Recent imaging showed a lesion near the original tumor site. He underwent repeat craniotomy with subtotal excision. The patient's neurological status remained stable postoperatively, although headaches persisted. Discussion: Recurrent GBMs pose significant management challenges due to diagnostic complexity and limited treatment options. Multimodal imaging and individualized strategies, including surgery and potential adjuvant therapies, are critical. Conclusion: This case underscores the need for vigilant follow-up and a personalized, multidisciplinary approach to improve outcomes in patients with recurrent glioblastoma.