ArticleBrain tumor pathology2026
Dual TERT promoter mutations in glioblastoma, IDH-wildtype: a case report with preclinical investigations.
Article in Brain tumor pathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Telomerase reverse transcriptase promoter (TERTp) mutations c.-124C > T (C228T) and c.-146C > T (C250T) are the most frequent single-nucleotide variants promoting telomerase activation in glioblastoma. Here, we describe a rare case of glioblastoma IDH-wildtype with dual TERTp mutations. Genomic analyses of multiregional tumor samples revealed co-occurring TERT C228T and C250T mutations across tumor regions, with variable copy number alterations of EGFR and CDKN2A. Notably, only the TERTp C228T mutation was retained in the corresponding patient-derived xenograft, accompanied by more extensive copy number alterations, implying a selective growth advantage for the TERT C228T-harboring subclone during tumor propagation in this case. These findings suggest that dual TERTp mutations may arise through subclonal evolutionary processes in glioblastoma and highlight telomere maintenance as a dynamic, heterogeneous process rather than invariably representing a fixed early oncogenic event.
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