Glioblastoma multiforme -Endothelial proliferationor necrosison histology makes the tumorgrade IV. - Know asbutterfly tumoras it crosses midline - Seen inolder patient (> 50 years) - Grows rapidly, - Tumor often contains a necrotic core that occurs as its growth surpasses its blood supply. - MRI Irregular shape, Poor demarcation from surrounding brain tissue Presence of variable amount of surrounding white-matter edema. -Treatment: Cytoreductive surgeryfollowed byEB. The extent of tumor resectionbhas asignificant effecton time to tumorprogressionand mediansurvival. Carmustineandcisplatinhave been the primary agents used againstmalignant gliomas. Temozolomide has shown some promise in the management ofnewly diagnosedandrecurrent GBM,with an overall surl time of 13.6 months. -Median survivaltime forGBMis<1 year.