Basal ganglia glioblastoma with lung adenocarcinoma tumor-to-tumor metastasis and atypical early imaging presentation: illustrative case

This case highlights the importance of maintaining diagnostic suspicion for dual pathology in atypical intracranial lesions with progressive, otherwise unexplained symptoms. Furthermore, this case highlights the challenges in recognizing early glioblastoma presenting with nonenhancing, diffusion-restricting imaging features that may closely mimic subacute ischemic stroke. The integration of histopathology, immunochemistry, and molecular profiling is critical in recognizing this entity and carries significant implications for accurate diagnosis and treatment. https://thejns.org/doi/10.3171/CASE25992.