We discuss a case series and review of the literature, which includes a 63 yo male who presented to the emergency room with a 2-week history of falls and new-onset seizures. MRI brain with gadolinium contrast confirmed a large, heterogeneously enhancing mass with evidence of central necrosis. There was a broad attachment with a “dural tail” feature. During the craniotomy, the mass was noted to have a grey, firm consistency, which directly extended into the overlying dura. Final pathology revealed a WHO grade IV astrocytoma with meningeal invasion. Recovery after surgery was uncomplicated, and he was discharged on post-operative day five. Twelve months after diagnosis, the patient was doing well neurologically with a stable disease burden on follow-up MRI.
Of the 7 patients in our case series who presented with rare GBMs with dural tails, 5/7 had favorable outcomes including good neurological functioning for more than 2 years on follow-up. This is significant since the median age of survival is between 6-12 months and only 6.4% of GBM patients typically survive longer than 2 years.