Gliosarcoma With Features of Osteoblastic Osteosarcoma: A Review

Abstract

Context.—Gliosarcoma is a rare tumor of the central nervous system characterized by a biphasic histologic pattern, consisting of a gliomatous and a sarcomatous component, respectively. In most instances the sarcomatous component is represented by a fibrosarcoma, but other stromal malignancies have also been described. Osteosarcomatous differentiation in gliosarcoma has been rarely reported. Objective.—To review characteristic radiologic and histopathologic features of this rare neoplasm, to debate about possible differential diagnoses that should be taken into consideration, and to provide an overview of the potential histopathogenesis of gliosarcomas. Data Sources.—Relevant articles indexed in PubMed (National Library of Medicine) and reference medical texts. Conclusions.—Recent molecular studies suggest that sarcomatous and gliomatous components of gliosarcoma might be derived from a single precursor cell clone, progressing in 2 subclones with distinct morphologic features during tumor evolution. Nonetheless, events determining splitting of the original clone into 2 histologic populations remain to be investigated.

the Irradiation of Two Cases of Gliosarcoma: Place and Modalities of Radiotherapy

“…Peak incidence is seen in the sixth and seventh decades of life (1,2). GSM are clinically indistinguishable from GBM (9).…”

“…Histologically two GSM subtypes have been identified and described, each having its own prognosis and treatment plan (13). Sarcomatous predominant GSM is characterized by its similarity to meningioma, production of reticulin and lack of GFAP positivity; gliomatous predominant GSM is characterized by necrosis seen on pathological examination, lack of reticulin and expression of GFAP (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

Transformation of IDH-wildtype glioblastoma to gliosarcoma with features of osteosarcoma

“…Both components of gliosarcoma arise from clonal proliferation of the same precursors and result from a phenotypic change in the glioblastoma cells, reflecting the clonal evolution of a tumor. Electron microscopy and immunohistochemical studies indicate that these precursors can include fibroblasts, mesenchymal pluripotent cells, vascular adventitia or perivascular and vascular spaces of smooth muscle cells [3].…”

“…Vimentin is a common positive marker for sarcomas, but not for gliomas [1,4,5,15]. The loss of s100 staining in the spindle cells of the sarcoma area is noteworthy, as it can accompany mesenchymal transition in glioblastoma [3]. The median survival following secondary gliosarcoma is estimated at 6.6 months (range 1.2-9.0 months).…”

Gliosarcoma with osteosarcomatous component: A case report and short review illustration

“…This speci c type of GS can be divided into two subtypes: primary GS (pGS) and secondary GS (sGS). The pGS with osteosarcomatous component was de novo, and the diagnosis was con rmed after the initial operation [1,12,[19][20][21]. Additionally, there was no history of radiotherapy and no history of another organ osteosarcoma.…”