Pineal GBM is a rare disease that is associated with a poor prognosis. The majority of patients present with signs of increased intracranial pressure and visual symptoms. It is difficult to draw conclusions from the small number of total patients reported over a number of decades with differing treatment paradigms. This is the first pineal region GBM that reports positive MGMT promoter methylation and use of bevacizumab upon progression. Our case suggests that durable control of the disease can potentially be achieved in the absence of a gross total surgical resection. Further research in the role of MGMT methylation as a prognostic indicator and of the response of pineal region GBM to bevacizumab is warranted ¹⁾.