Secondary gliosarcoma: a review of clinical features and pathological diagnosis

Journal of Neurosurgery - Tập 112 Số 1 - Trang 26-32 - 2010
Seunggu J. Han1, Isaac Yang2,3, Tarık Tihan4, Susan M. Chang2,3, Andrew T. Parsa2,3
1Department of Neurological Surgery, University of California, San Francisco, California 94117, USA.
2Departments of Neurological Surgery, and
3University of California at San Francisco
42Pathology, University of California, San Francisco, California

Tóm tắt

Object

Although secondary gliosarcoma after treatment of primary glioblastoma multiforme has been described, little is known of these rare tumors. In this article the authors review the literature on secondary gliosarcoma, with attention to clinical course and pathological features.

Methods

A PubMed search of the key word intracranial “gliosarcoma” with and without “radiation” or “radiotherapy” in humans was performed. The 204 citations yielded were screened for relevancy to gliosarcomas that occur after treatment of previous intracranial neoplasms.

Results

A search of the literature yielded 24 relevant articles, combined for a total of only 12 cases of secondary gliosarcoma and 12 cases of radiation-induced gliosarcoma. Of the 12 cases of secondary gliosarcoma, all were previously treated with surgery and radiotherapy (mean dose 50.7 Gy), with a mean survival of 13 months since time of gliosarcoma diagnosis (range 6.9–19.4 months). In the cases of radiation-induced gliosarcoma, the mean dose of previous radiotherapy was 51.3 Gy (median 54 Gy, range 24–60 Gy), and the mean survival since gliosarcoma diagnosis was 6.7 months (median 6 months, range 2–10 months).

Conclusions

Secondary gliosarcoma and radiation-induced gliosarcoma are exceedingly rare. The literature on secondary gliosarcoma illustrates a more favorable survival than for primary gliosarcoma but remains limited regarding clinical and radiographic presentation, response to treatment, and pathogenesis. The results of the present review also support the notion that secondary gliosarcomas and radiation-induced gliosarcomas are distinct entities, with longer survival and shorter latency of gliosarcoma induction seen in the former. Efforts to elucidate the role of radiotherapy in the induction of gliosarcomas may yield new insights into therapeutic risks of cranial radiation and CNS tumor pathogenesis.

Từ khóa


Tài liệu tham khảo

Actor, 2002, Comprehensive analysis of genomic alterations in gliosarcoma and its two tissue components, 34, 416

Averback, 1978, Mixed intracranial sarcomas: rare forms and a new association with previous radiation therapy, 4, 229

Beaumont, 2007, Gliosarcoma with multiple extracranial metastases: case report and review of the literature, 83, 39

Behling, 2004, Gliosarcoma arising from an anaplastic ependymoma: a case report of a rare entity, 35, 512

Beute, 1991, Cerebellar gliosarcoma: report of a probable radiation-induced neoplasm, 12, 554

Biernat, 1995, Identical mutations of the p53 tumor suppressor gene in the gliomatous and the sarcomatous components of gliosarcomas suggest a common origin from glial cells, 54, 651

Boerman, 1996, The glial and mesenchymal elements of gliosarcomas share similar genetic alterations, 55, 973

Deb, 2006, Giant cell glioblastoma multiforme: report of a case with prolonged survival and transformation to gliosarcoma, 22, 314

Dropcho, 1991, Central nervous system injury by therapeutic irradiation, 9, 969

Feigin, 1958, The endothelial hyperplasia of cerebral blood vessels with brain tumors, and its sarcomatous transformation, 2, 264

Feigin, 1955, Sarcoma arising in glioblastoma of the brain, 31, 633

Galanis, 1998, Clinical outcome of gliosarcoma compared with glioblastoma multiforme: North Central Cancer Treatment Group results, 89, 425

Jager, 2008, Induction of gliosarcoma and atypical meningioma 13 years after radiotherapy of residual pilocytic astrocytoma in childhood, 44, 153

Kaschten, 1995, Radiation-induced gliosarcoma. Case report and review of literature, 83, 154

Kawaguchi, 1991, Two autopsied cases of radiation-induced gliosarcoma, 19, 285

Kepes, 1996, Gliosarcoma developing from an irradiated ependymoma, 92, 515

Lach, 1996, Radiation-associated gliosarcoma, 47, 209

Lieberman, 2001, Postradiation gliosarcoma with osteosarcomatous components, 43, 555

Lutterbach, 2001, Gliosarcoma: a clinical study, 61, 57

Malde, 2004, Gliosarcoma occurring 8 years after treatment for a medulloblastoma, 20, 243

McComb, 1982, Immunohistochemical detection of factor vii /von Willebrand factor in hyperplastic endothelial cells in glioblastoma multiforme and mixed glioma-sarcoma, 41, 479

Meis, 1991, Mixed glioblastoma multiforme and sarcoma. A clinicopathologic study of 26 radiation therapy oncology group cases, 67, 2342

Miller, 2007, Glioblastoma, 131, 397

Pasquier, 1978, Sarcoma arising in oligodendroglioma of the brain, 42, 2753

Perry, 1995, Clinicopathologic features of primary and postirradiation cerebral gliosarcoma, 75, 2910

Reis, 2000, Genetic profile of gliosarcomas, 156, 425

Schrantz, 1972, Radiation induced meningeal fibrosarcoma, 93, 26

Shapiro, 1989, Radiation-induced malignant gliomas, 71, 77

Slowik, 1980, Extracranial spreading of glioblastoma multiforme, 41, 57

Slowik, 1985, Gliosarcomas: histological, immunohistochemical, ultrastructural, and tissue culture studies, 67, 201

Weaver, 1984, Selective peripancreatic sarcoma metastases from primary gliosarcoma. Case report, 61, 599

Wharton, 2001, Gliosarcoma with areas of primitive neuroepithelial differentiation and extracranial metastasis, 20, 212