Brain Tumor Res Treat.  2018 Oct;6(2):78-81. 10.14791/btrt.2018.6.e11.

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

• Yoon GY
• Oh HJ
• Oh JS
• Yoon SM
• Bae HG

• KMID: 2423978
• DOI: http://doi.org/10.14791/btrt.2018.6.e11

Abstract

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.

Keyword

Gliosarcoma; Sarcomatous glioma

MeSH Terms

Aged
Central Nervous System
Cranial Fossa, Posterior
Craniotomy
Diagnosis
Dizziness
Gait
Glioblastoma
Gliosarcoma*
Humans
Magnetic Resonance Imaging

Figure

• 

  Fig. 1 Brain imaging before surgery. A: Contrast enhanced CT in huge densely enhancing solid mass with peripheral cystic component in the left posterior fossa, attached the left tentorium, with surrounding brain edema. B–D: Gadolinium-enhanced MRI demonstrated 5.6×4.8×3.2 cm sized mass lesion in left posterior cranial fossa, heterogeneously enhanced. There were no diffusion-weighted imaging and gradient echo imaging.

• 

  Fig. 2 Histology of gliosarcoma is shown. A: Hematoxylin and eosin stain of the gliomatous component. Glioma cells show polymorphic significantly with tumor necrosis (×100). B: Glial fibrillary acidic protein (GFAP) staining show gliomatous component with strong diffuse GFAP expression (×200). C: Focal GFAP staining is observed between sarcomatous component (×200). D: Diffuse reticulin-rich tumor cells suggest sarcomatous component in reticulin stain (×200).

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