Gliosarcoma: a clinical and radiological analysis of 48 cases

Abstract

• Diagnosis of gliosarcoma can be suggested preoperatively by imaging. • Gliosarcoma can be divided into four subtypes based on MRI. • Paliform pattern and ECP tend to present in gliosarcoma more than GBM. • The cystic subtype of gliosarcoma may predict a more dismal prognosis. • All gliosarcoma patients should receive adjuvant therapy to achieve better prognosis.

Clinical Characteristics of Gliosarcoma and Outcomes From Standardized Treatment Relative to Conventional Glioblastoma

“…It was recently proposed that the GS diagnosis could be estimated by preoperatively imaging analysis (27), but this is conflicted by a study finding a slightly larger area of edema to be the only distinct feature of GS compared to conventional GBM tumors upon evaluation of the radiological VASARI feature set (51). Radiological analysis of our PGS patients revealed that 58% had a peripheral tumor abutting dura, consistent with previous reported imaging characteristics (28)(29)(30)(31).…”

“…SGS are distinguished from radiation therapy (RT)-induced GS, which arise after intracranial RT in patients without any prior presence of GBM (21)(22)(23)(24). GS most often affects adults in the fifth to seventh decade of life, with a male predominance, and has a temporal lobe predilection (4)(5)(6)(25)(26)(27). On imaging GS lesions typically present as a well-demarcated supratentorial mass often peripherally located and abutting dura (26)(27)(28)(29)(30)(31).…”

“…GS most often affects adults in the fifth to seventh decade of life, with a male predominance, and has a temporal lobe predilection (4)(5)(6)(25)(26)(27). On imaging GS lesions typically present as a well-demarcated supratentorial mass often peripherally located and abutting dura (26)(27)(28)(29)(30)(31). While these imaging features are more likely to occur in GS compared to conventional GBM, it is still not possible to diagnose GS by imaging alone (27,30).…”

“…On imaging GS lesions typically present as a well-demarcated supratentorial mass often peripherally located and abutting dura (26)(27)(28)(29)(30)(31). While these imaging features are more likely to occur in GS compared to conventional GBM, it is still not possible to diagnose GS by imaging alone (27,30). The growth pattern of GS tumors may differ from that of conventional GBM, as extracranial (EC) metastasis has been reported in up to 11% of GS (32), which is far more than among conventional GBM patients, with <2% of cases metastasizing (33,34).…”

Diagnostik und Differenzialdiagnostik von Erkrankungen der Hirnhäute

“…Im Gegensatz zu Meningeomen lassen sich Verkalkungen und eine Reaktion des angrenzenden Knochens nicht nachweisen und es kann zu intratumoralen Einblutungen kommen. Nach Kontrastmittelgabe zeigen die Tumoren eine kräftige Mehranreicherung [16]. Aufgrund des i. d. R. großen intrazerebralen Tumoranteils ist die Abgrenzung zu einem Meningeom i. d. R. gut möglich.…”