Brain glioblastoma is an acquired tumor caused by somatic genetic and epigenetic changes in glial precursor cells. The vast majority of cases are sporadic. Established risk factors are limited: prior therapeutic cranial radiation is recognized, and incidence increases with age. A small subset occurs in rare inherited cancer-predisposition syndromes such as Li-Fraumeni syndrome, neurofibromatosis type 1, and Lynch syndrome. The disease is not inherited in most cases, and genetic counseling is generally not indicated unless a predisposition syndrome is suspected.

Brain MRI with and without contrast is the initial imaging study and often shows a contrast-enhancing mass with central necrosis and surrounding edema. Definitive diagnosis requires tissue examination through surgical biopsy or resection, with neuropathology review and integrated molecular testing per current WHO classification standards. The differential diagnosis may include other high-grade gliomas, brain metastases, primary CNS lymphoma, and certain infectious or inflammatory conditions; imaging and pathology help distinguish among these.

Treatment planning depends on disease stage, tumor characteristics, and overall health. Care typically involves a multidisciplinary neuro-oncology team — neurosurgery, radiation oncology, medical oncology, and supportive care — and may include maximal safe surgical resection, radiation therapy, systemic treatment approaches, and supportive care. Treatment goals are individualized. Additional therapies are under investigation through clinical trials. Individuals should consult their healthcare provider to discuss options.

Brain glioblastoma is an aggressive disease. Outcomes depend on age, functional status, extent of safe surgical resection, the tumor's molecular features, and access to multidisciplinary neuro-oncology care. With current standards of care, treatment can improve both survival and quality of life for many individuals, although the overall course remains serious and outcomes vary. Prognosis should be discussed with the treating clinical team.

Brain glioblastoma is an active area of research, with numerous ongoing clinical trials. Themes include targeted therapies, immunotherapies (therapeutic vaccines, CAR-T cell therapies, immune checkpoint inhibitors), tumor-treating fields, and molecular subtype-directed therapies. Individuals interested in clinical trials can search ClinicalTrials.gov or consult their care team.