Malignant brain tumour with challenging intraoperative findings

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.