Extensive epidural extension growth of a glioblastoma: a case report and literature review

It is extremely rare for a glioblastoma to mainly have epidural growth after its invasion of the dura. The present paper reports such a rare case. The patient was a 37-year-old male. After the onset of headache, computed tomography (CT) examination revealed an extradural convex-shaped lesion on the frontal region that was mainly epidural. During the first surgery, the extradural lesion mainly consisted of bloody viscous liquid; therefore, it was misdiagnosed as simple epidural bleeding, and the best diagnosis and treatment opportunity were missed. One month later, a relapse of the disease occurred, with a symptom of exophthalmos. Imaging examination revealed extensive extradural growth of the lesion along the forehead and invasion downwards into the frontal sinus, sphenoidal sinus, ethmoidal sinus and orbit. The second surgery could not completely remove the lesion, and pathological diagnosis of the lesion was a glioblastoma. One month later, the glioblastoma continued to grow, the third operation was performed, this time most of tumor was removed, the treatment was assisted with radiotherapy and chemotherapy, the tumor was controlled effectively, and the patient did well after six months. While reporting this rare case, we also review the cases of glioblastoma invasion of the dura and their growth and the classification of dura invasions, aiming at improving our understanding in cases of glioblastoma invasion of the dura so that we can make timely, accurate diagnoses.