Butterfly Glioblastoma Multiforme: Histological Origin, Molecular Pathology and Contemporary Management

Abstract

Glioblastoma multiforme (GBM), now classified "glioblastoma, IDH-wildtype" in the fifth edition of the World Health Organization (WHO) Classification of Tumours of the Central Nervous System, is the most prevalent and deadly primary malignant brain tumour of adulthood. A distinctive and unusually aggressive anatomical presentation is the so-called "butterfly glioma" involving the corpus callosum which extends symmetrically or asymmetrically into both cerebral hemispheres to produce a wing-like, bat-shaped configuration on cross-sectional imaging. This review synthesises current understanding of the histological origin, molecular pathogenesis, diagnostic classification, histopathological features, and evolving management of glioblastoma, with particular emphasis on the butterfly variant and on developments reported in 2025-2026 including tumour-treating fields combined with immunotherapy, oncolytic viral therapy, and novel cell-of-origin research implicating subventricular zone neural stem cell.