Glioblastoma infiltrating into the cavernous sinus: Case report of an unusual pattern of invasion with review of literature highlighting clinical implications

Abstract Glioblastomas are highly malignant tumors which rapidly invade into surrounding neural elements but rarely invade venous sinuses, with invasion of cavernous sinus even rarer. In this study, we present a case of a 58-year-old male with right temporal large glioblastoma which was invading into the cavernous sinus. During surgery, the cavernous sinus breach was seen, and the tumor was delivered out gently, decompressing the displaced oculomotor nerve. Post-surgery, the patient developed oculomotor paresis. The invasion of venous sinus increases the risk of sinus thrombosis and extra-neural metastasis. Cavernous sinus has critical neuro-vascular structures, thus making the surgery challenging. This is a unique case as invasion of cavernous sinus from an intra-axial glioblastoma is extremely rare, and we are reporting this for the first time in the literature. Careful preoperative radiological assessment can increase the possibility of such invasion. Microsurgical resection is warranted, balancing the neurological morbidity of extensively radical resections in the region of the cavernous sinus.