Computed Tomography, Magnetic Resonance Imaging, and Pathological Features of Gliosarcoma

Abstract

To investigate the clinical, imaging, and pathological features of gliosarcoma. Methods: The clinical data of 14 patients with gliosarcoma confirmed by surgery and pathology at our hospital between 2010 and 2021 were analyzed retrospectively, and the relevant literature was reviewed.Results: In all 14 cases, the gliosarcoma was located in the supratentorial brain parenchyma and involved a single lesion. There were more male patients (64.3%) than female patients (35.7%), and 57.1% of all the patients were 40-60 years of age. The prognosis of all 14 patients was poor, and the average survival time was approximately seven months. The computed tomography findings revealed mostly mixed density lesions, and some cases were complicated with bleeding. The magnetic resonance imaging revealed irregularly shaped mass lesions of different sizes, with uneven or circular enhancement. Cystic degeneration and necrosis could be seen in all the masses, some of which showed signs of bleeding and were surrounded by different degrees of edema and space-occupying effects. The pathological examination revealed that the tumors had bidirectional differentiation of the glial and sarcoma components, while the immunohistochemistry examination revealed glial fibrillary acidic protein-positive and reticular fiber-positive staining in the sarcoma. Conclusion:The clinical manifestations of gliosarcoma are nonspecific, but imaging reveals that the condition has certain characteristics, typically consisting of a huge supratentorial mass, with an irregular heterogeneous periphery or obvious mass-like augmentation after enhancement. The final diagnosis depends on the results of a pathological examination.

The 2021 World Health Organization Central Nervous System Tumor Classification: The Spectrum of Diffuse Gliomas

“…The rim of enhancing tissue is hypercellular and exhibits high cell turnover; on imaging, this is depicted by diffusion restriction, contrast enhancement, and high relative cerebral blood volume on perfusion. Patchy or no enhancement may also occur [ 85 , 86 , 87 ]. Moreover, glioblastomas have the capability to spread into adjacent lobes and deeply infiltrate the brainstem [ 88 ].…”