Abstract

Background: High-grade gliomas are among the most aggressive and malignant primary brain tumors, characterized by rapid progression, invasiveness, and overall poor prognosis. This is particularly pronounced in elderly patients, who frequently present with multiple comorbidities, reduced physiological reserve, and diminished treatment tolerance. These factors complicate therapeutic decision-making and necessitate a nuanced approach that balances the goals of effective tumor control with the preservation of neurological function, independence, and overall quality of life. The management of such tumors in this vulnerable population remains a significant clinical challenge, underscoring the need for multidisciplinary care strategies that integrate both oncological and supportive interventions. Case presentation: We report the clinical case of an 81-year-old right-handed woman who presented with a three-week history of progressive cognitive decline, behavioral changes, and gait instability, severely impacting her daily functioning. Neuroimaging revealed a cortico-subcortical lesion extensively involving the right temporal, parietal, and frontal lobes, raising suspicion for a high-grade neoplasm. Subsequent stereotactic biopsy and histopathological analysis confirmed the diagnosis of a high-grade glioma consistent with an IDH-wildtype glioblastoma. Following the procedure, the patient experienced neurological deterioration, prompting the initiation of a hypofractionated radiotherapy regimen tailored for elderly patients. In parallel, early integration of palliative care services was implemented to optimize symptom management, address psychosocial needs, and support shared decision-making with the patient and family. Conclusion: In elderly patients diagnosed with high-grade gliomas, adopting a multidisciplinary treatment framework that combines oncological, surgical, and palliative care is essential. Early initiation of palliative interventions facilitates optimal symptom control, preserves functional capacity, enhances quality of life, and supports patientcentered clinical decision-making throughout the disease course.

Keywords

high-grade glioma, elderly patients, palliative care, multidisciplinary approach