Cerebral gliosarcoma: clinico-pathologic study of 8 cases

ABSTRACT

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. Our objective is to specify clinical and pathological characteristics of this rare noeoplasm and to discuss its histogenesis. 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. 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 conmon location was parietal or temporo-parietal [5 cases 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]. Clinical, radiological and follow-up features of gliosarcomas share great similarities with glioblastomas. Histopathological, histochemical and inmmnohistochemical studies are helpful in accuracy diagnosis. Recent cytogenetic and molecular data support a monoclonal origin for these tumors