Primary glioblastoma mimicking brain metastasis in ALK-positive lung adenocarcinoma: a case report and literature review

作者：Mengyuan Li, Hanghuang Jin, Jianhua Luo, Cheng Zheng · 发表于：Frontiers in Oncology · 年份：2026 · DOI：10.3389/fonc.2026.1837876 · 被引用次数：1 · 研究领域：Multiple and Secondary Primary Cancers、Brain Metastases and Treatment、Glioma Diagnosis and Treatment

In patients with a known diagnosis of lung cancer, a new intracranial space-occupying lesion is most frequently interpreted as a brain metastasis. However, distinguishing it from an independent double primary brain tumor is critical, as treatment strategies and prognoses differ substantially. We report a rare case of primary glioblastoma occurring approximately two years after surgery for anaplastic lymphoma kinase (ALK)-positive lung adenocarcinoma. A 63-year-old female underwent radical resection for stage IA lung adenocarcinoma (ALK-positive) and received adjuvant ensartinib. Two years postoperatively, brain magnetic resonance imaging (MRI) revealed a solitary lesion in the right centrum semiovale, which was clinically misdiagnosed as a brain metastasis. The patient was subsequently treated with lorlatinib combined with stereotactic radiotherapy. Despite these interventions, she developed progressive left-sided limb weakness, and imaging demonstrated continuous lesion progression. Subsequent surgical resection and pathological examination confirmed primary glioblastoma, strongly supporting a diagnosis of metachronous double primary cancers (DPCs). The patient died 10 months after the glioblastoma diagnosis. This case highlights that during long-term follow-up of patients with malignancies, a new intracranial lesions may warrant consideration of a second primary cancer (SPC), particularly when the treatment response is not consistent with the expected biology of the origina...