Objective: To discuss the clinical and radiological characteristics of multiple glioblastoma multiforme (GBM) and help clinicians to diagnose GBM in early stage.

Methods: The process of clinical diagnosis and treatment of a patient with multiple GBM was reported. Neurology and imaging experts were invited to discuss the clinical and imaging characteristics of GBM based on literature reviews.

Results: One patient was diagnosed of multiple GBM with the onset of seizures and a history of transient memory loss. Cerebrospinal fluid (CSF) examination showed no indications for malignant tumors. Cranial magnetic resonance imaging (MRI) demonstrated multiple subcortical lesions which exhibited hypo-intense on T1-weighted image and hyper-intense on T2-weighted image and fluid attenuated inversion recovery (FLAIR) image; there was also hyper-intense on diffusion weighted imaging (DWI) with patchy enhancement. Magnetic resonance spectroscopy (MRS) showed elevated choline level in the lesion sites. The final pathological diagnosis was glioblastoma multiforme, not otherwise specified (NOS).

Conclusion: GBM is the most prevalent and malignant primary brain tumor and its clinical manifestations are diverse and untypical. Computed tomography (CT) and enhanced MRI examinations show no specificity of the lesions. GBM should be distinguished from cerebrovascular diseases and intracranial metastatic tumors. MRS can analyze the metabolism of the lesions to help identifying the lesions properly.