Cerebral Gliosarcoma: Clinico-pathologic study of 8 cases

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Published Mar 1, 2010
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Vol. 88 No. 3 (2010): Issue Mar 2010

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Lobna Ayadi
Slim Charfi
Abdelmajid Khabir
Rim Kallel
Ahmed Sellami
Saloua Makni
Laboratoire d'Anatomie et de Cytologie Pathologiques
Zaher Boudawara
Tahya Sellami-Boudawara

Abstract

Background : Gliosarcomas are biphasic neoplasms composed of a glioblastoma admixed to a sarcomatous component with different lines of differentiation. Histogenesis of these tumors is still discussed.
Aim: Our objective is to specify clinical and pathological characteristics of this rare neoplasm and to discuss its histogenesis.
Methods: Retrospective study of eight cases of gliosarcomas diagnosed between January 1998 and December 2004. Clinical, radiological, therapeutic and follow-up data were reviewed. Histological features and immunohistochemical results were also included in this review.
Results: Five patients were male, three women with a median age of 50.7 (range 31-74 years). Symptoms were dominated by intracranial hypertension and paralysis. The most common location was parietal or temporo-parietal (5cases: 62.5%). Pathological exam including histochemical and immunohistochemical study confirmed the diagnosis of gliosarcoma in all cases. Sarcomatous component had features of fibrosarcoma in 5 cases, osteosarcoma in 2 cases and
malignant fibrous histiocytoma in 1 case. All patients were treated by surgical excision (complete in five cases and partial in three cases). Adjuvant radiotherapy was received in three cases. One patient was lost on follow-up. Two patients died from postoperative complications and the five remaining patients died with a medium follow up of 9 months (extremes: 2-24 months).
Conclusion: Clinical, radiological and follow-up features of gliosarcomas share great similarities with glioblastomas. Histopathological, histochemical and immunohistochemical studies are helpful in accuracy diagnosis. Recent cytogenetic and molecular data support a monoclonal origin for these tumors.

Keywords:

Glioblastoma, Gliosarcoma, Histogenesis, Immunohistochemistry

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