Primary Cerebellar Gliosarcoma with Extracranial Metastases: An Orphan Differential Diagnosis

Nsir, Atef Ben; Thai, Quoc Anh; Kassar, Alia Zehani; Said, I. Ben; Jemel, Hafedh

doi:10.1016/j.wneu.2015.07.049

Cited by 9 publications

(6 citation statements)

References 13 publications

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“…Although the dural tail is actually one of the most frequent radiological features of GS, the sharply demarcated or irregular borders, and the remarkable perilesional edema, should always put metastases among the possible differential diagnosis [6–8]. This is particularly relevant in light of the potential extracranial localizations of GSs described in many cases of supratentorial primary lesions but also in one case from the infratentorial series described in Table 1 [16]. GSs pose several technical challenges to the operating team: they tend to be highly vascularized, carrying a significant risk of intraoperative blood loss and postoperative hematoma [25, 26].…”

Section: Discussionmentioning

confidence: 99%

Primary Gliosarcoma of the Cerebellum in a Young Pregnant Woman: Management Challenges and Immunohistochemical Features

Meloni

Serra

Bellisano

et al. 2019

Case Reports in Surgery

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Background. Gliosarcoma (GS) represents a rare, high-grade (WHO Grade IV), central nervous system neoplasm, characterized by a very poor prognosis. Similar to other high-grade gliomas, GS affects mainly adults in the 5th-7th decade of life and presents a higher incidence in males. The most reported locations of GS are the temporal lobe and the frontal lobe, while only eight cases of GS originating from the posterior cranial fossa are reported in the literature. Case Description. We report the first case occurring during pregnancy in a 33-year-old patient. Diagnosis was obtained on the 15th week of gestation when patient presented with signs and symptoms of life-threatening raised intracranial pressure. Surgical excision was followed by early recurrence and eventually disease progression because the patient refused adjuvant treatment to save her fetus. Conclusions. GS should be considered in the differential diagnosis of posterior cranial fossa tumors with radiological features of meningioma or glioblastoma, even in young patients. To this regard, sarcomas, solitary fibrous tumors, and even metastases should be considered, especially in light of the tendency of GS to give rise to extracranial localizations. Whenever an aggressive management with radical excision and adjuvant treatment is not safely achievable, disease progression is likely to be unavoidable.

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Section: Discussionmentioning

confidence: 99%

Primary Gliosarcoma of the Cerebellum in a Young Pregnant Woman: Management Challenges and Immunohistochemical Features

Meloni

Serra

Bellisano

et al. 2019

Case Reports in Surgery

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“…Since first description of GS in 1895, almost previous reported articles of GS were located predominantly in the supratentorial area, representing for 1.8–10% of all GBMs [ 9 ]. Ng and Poon [ 10 ] first reported on a case of radiation induced cerebellar GS in 1990, several case reports about cerebellar GS have been published ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…Ng and Poon [ 10 ] first reported on a case of radiation induced cerebellar GS in 1990, several case reports about cerebellar GS have been published ( Table 1 ). Only very few cases have been reported about primary GS in infratentorial region [ 9 10 11 12 13 14 ].…”

Section: Discussionmentioning

confidence: 99%

Gliosarcoma of Cerebello-Pontine Angle: A Case Report and Review of the Literature

Yoon

et al. 2018

Brain Tumor Res Treat

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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 5.6×4.8×3.2 cm 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.

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“…The tumor is predominantly located in the temporal lobe, is often located superficially, presents surgically as a firm lesion adherent to the meninges, and has occasionally been mistaken for meningioma during surgery. Pathologically, gliosarcoma is defined as a glioblastoma variant consisting of an admixture of gliomatous and sarcomatous components, and presents in around 2% of glioblastoma cases [12]. The glial component is pleomorphic astrocytic cells with immunopositivity for glial fibrillary acidic protein, and the sarcomatous component shows malignant changes of spindle cells with immunopositivity for vimentin and S-100.…”

Section: Discussionmentioning

confidence: 99%

“…Gliosarcomas are uncommon malignant brain tumor, composed of mixed gliomatous and sarcomatous component [12]. Gliosarcoma is a rare variant of glioblastoma and comprise 1.8–8% of glioblastoma [3].…”

Section: Introductionmentioning

confidence: 99%

A Stable Secondary Gliosarcoma with Extensive Systemic Metastases: A Case Report

Choi

Cheon

Jung

et al. 2016

Brain Tumor Res Treat

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A 63-year-old man complained of intermittent motor weakness of his arm. The magnetic resonance image (MRI) of his brain displayed a high signal lesion in right cingulate gyrus on T2 weighted image. One year later, he showed a stuporous mental status with repeated seizures, and the follow-up brain MRI showed heterogeneously enhanced mass associated with bleeding. He was treated with surgery and radiotherapy for secondary glioblastomas in right cingulate gyrus. One year more later, a mass recurred on the left frontal base, and gliosarcoma was diagnosed. After tumor resection, ventriculoperitoneal shunt, chemotherapy, and re-radiation therapy, all brain lesions were stable. Fourteen months after the diagnosis of gliosarcoma, he complained of dyspnea and back pain. Torso positron emission tomography/computed tomography revealed multiple metastatic lesions in both lungs, pericardium, pleura, liver, lymph nodes, and bones, and metastatic gliosarcoma was diagnosed. One month later, the patient died because of the systemic metastases. We present an unusual case of secondary gliosarcoma with stable brain lesions and extensive systemic metastases.

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Primary Cerebellar Gliosarcoma with Extracranial Metastases: An Orphan Differential Diagnosis

Cited by 9 publications

References 13 publications

Primary Gliosarcoma of the Cerebellum in a Young Pregnant Woman: Management Challenges and Immunohistochemical Features

Primary Gliosarcoma of the Cerebellum in a Young Pregnant Woman: Management Challenges and Immunohistochemical Features

Gliosarcoma of Cerebello-Pontine Angle: A Case Report and Review of the Literature

A Stable Secondary Gliosarcoma with Extensive Systemic Metastases: A Case Report

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