Brain Tumor Research and Treatment

The Korean Brain Tumor Society (대한뇌종양학회)
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Gliosarcoma of Cerebello-Pontine Angle: A Case Report and Review of the Literature

  • Yoon, Gi-Yong (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Oh, Hyuk-Jin (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Oh, Jae-Sang (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Yoon, Seok-Mann (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital) ;
  • Bae, Hack-Gun (Department of Neurosurgery, Soonchunhyang University Cheonan Hospital)
  • Received : 2018.06.12
  • Accepted : 2018.08.31
  • Published : 2018.10.31
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Abstract

Gliosarcoma (GS), known as variant of glioblastoma multiforme, is aggressive and very rare primary central nervous system malignant neoplasm. They are usually located in the supratentorial area with possible direct dural invasion or only reactive dural thickening. However, in this case, GS was located in lateral side of left posterior cranial fossa. A 78-year-old man was admitted to our hospital with 3 month history of continuous dizziness and gait disturbance without past medical history. A gadolinium-enhanced MRI demonstrated $5.6{\times}4.8{\times}3.2cm$ sized mass lesion in left posterior cranial fossa, heterogeneously enhanced. The patient underwent left retrosigmoid craniotomy with navigation system. The tumor was combined with 2 components, whitish firm mass and gray colored soft & suckable mass. On pathologic report, the final diagnosis was GS of WHO grade IV. In spite of successful gross total resection of tumor, we were no longer able to treat because of the patient's rejection of adjuvant treatment. The patient survived for nine months without receiving any special treatment from the hospital.

Keywords

References

  1. Kozak KR, Mahadevan A, Moody JS. Adult gliosarcoma: epidemiology, natural history, and factors associated with outcome. Neuro Oncol 2009;11:183-91. https://doi.org/10.1215/15228517-2008-076
  2. Galanis E, Buckner JC, Dinapoli RP, et al. Clinical outcome of gliosarcoma compared with glioblastoma multiforme: North Central Cancer Treatment Group results. J Neurosurg 1998;89:425-30. https://doi.org/10.3171/jns.1998.89.3.0425
  3. Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol 2016;131:803-20. https://doi.org/10.1007/s00401-016-1545-1
  4. Zhang G, Huang S, Zhang J, Wu Z, Lin S, Wang Y. Clinical outcome of gliosarcoma compared with glioblastoma multiforme: a clinical study in Chinese patients. J Neurooncol 2016;127:355-62. https://doi.org/10.1007/s11060-015-2046-0
  5. Han SJ, Yang I, Tihan T, Prados MD, Parsa AT. Primary gliosarcoma: key clinical and pathologic distinctions from glioblastoma with implications as a unique oncologic entity. J Neurooncol 2010;96:313-20. https://doi.org/10.1007/s11060-009-9973-6
  6. Boerman RH, Anderl K, Herath J, et al. The glial and mesenchymal elements of gliosarcomas share similar genetic alterations. J Neuropathol Exp Neurol 1996;55:973-81. https://doi.org/10.1097/00005072-199609000-00004
  7. Reis RM, Konu-Lebleblicioglu D, Lopes JM, Kleihues P, Ohgaki H. Genetic profile of gliosarcomas. Am J Pathol 2000;156:425-32. https://doi.org/10.1016/S0002-9440(10)64746-3
  8. Actor B, Cobbers JM, Buschges R, et al. Comprehensive analysis of genomic alterations in gliosarcoma and its two tissue components. Genes Chromosomes Cancer 2002;34:416-27. https://doi.org/10.1002/gcc.10087
  9. Ben Nsir A, Thai QA, Kassar AZ, Ben Said I, Jemel H. Primary cerebellar gliosarcoma with extracranial metastases: an orphan differential diagnosis. World Neurosurg 2015;84:2076.e13-7. https://doi.org/10.1016/j.wneu.2015.07.049
  10. Ng HK, Poon WS. Gliosarcoma of the posterior fossa with features of a malignant fibrous histiocytoma. Cancer 1990;65:1161-6. https://doi.org/10.1002/1097-0142(19900301)65:5<1161::AID-CNCR2820650522>3.0.CO;2-F
  11. Nitta H, Hayase H, Moriyama Y, Yamashima T, Yamashita J. Gliosarcoma of the posterior cranial fossa: MRI findings. Neuroradiology 1993;35:279-80. https://doi.org/10.1007/BF00602614
  12. Moon SK, Kim EJ, Choi WS, Ryu CW, Park BJ, Lee J. Gliosarcoma of the cerebellar hemisphere: a case report and review of the literature. Korean J Radiol 2010;11:566-70. https://doi.org/10.3348/kjr.2010.11.5.566
  13. Chikkannaiah P, Bharath RD, Sampath S, Santosh V. De novo gliosarcoma occurring in the posterior fossa of a 11-year-old girl. Clin Neuropathol 2012;31:389-91. https://doi.org/10.5414/NP300479
  14. Duan H, Kitazawa K, Yako T, Ichinose S, Kobayashi S, Sudo M. Gliosarcoma in the cerebellopontine angle with rapid tumor growth and intratumoral hemorrhage. World Neurosurg 2016;92:580.e17-21. https://doi.org/10.1016/j.wneu.2016.06.053
  15. Frandsen J, Orton A, Jensen R, et al. Patterns of care and outcomes in gliosarcoma: an analysis of the National Cancer Database. J Neurosurg 2018;128:1133-8. https://doi.org/10.3171/2016.12.JNS162291
  16. Jain A, Correia J, Schweder P, McMahon A, Merola J, Aspoas R. Analysis of outcomes of multidisciplinary management of gliosarcoma: a single-center study, 2000-a2013. World Neurosurg 2017;106:30-6. https://doi.org/10.1016/j.wneu.2017.06.073
  17. Han L, Zhang X, Qiu S, et al. Magnetic resonance imaging of primary cerebral gliosarcoma: a report of 15 cases. Acta Radiol 2008;49:1058-67. https://doi.org/10.1080/02841850802314796
  18. Zhang BY, Chen H, Geng DY, et al. Computed tomography and magnetic resonance features of gliosarcoma: a study of 54 cases. J Comput Assist Tomogr 2011;35:667-73. https://doi.org/10.1097/RCT.0b013e3182331128