Primary glioblastoma mimicking brain metastasis in ALK-positive lung adenocarcinoma: a case report and literature review

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A 63-year-old female with ALK-positive lung adenocarcinoma developed a solitary brain lesion misdiagnosed as a metastasis two years post-surgery.
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The patient was treated with lorlatinib and stereotactic radiotherapy, but her condition worsened, leading to progressive neurological deficits.
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Pathological examination confirmed the lesion as primary glioblastoma, indicating a rare case of metachronous double primary cancers.
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This case emphasizes the importance of considering second primary cancers in patients with a history of malignancies and new intracranial lesions.
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Timely pathological confirmation and multidisciplinary review are crucial to avoid diagnostic delays and improve treatment outcomes.

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