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Pediatric gliosarcoma with fibrosarcomatous differentiation: report of a rare case
Shantha Ravisankar1, R Vimal Chander, Prem Kumar Devadoss
1Department of Pathology, Institute of Neurology, Madras Medical College, Chennai, India.
Insights
We report a rare pediatric case of primary gliosarcoma, a brain tumor with glial and mesenchymal features. This challenging diagnosis in an 11-year-old boy highlights the need for thorough histopathologic and immunohistochemical analysis.
Area of Science:
- Neuro-oncology
- Pediatric Pathology
- Rare Tumors
Background:
- Gliosarcoma, a rare glioblastoma variant, exhibits biphasic glial and mesenchymal differentiation.
- It predominantly affects adults, with pediatric occurrences being exceptionally rare.
Observation:
- A case of primary gliosarcoma with fibrosarcomatous differentiation in an 11-year-old boy is presented.
- The patient exhibited symptoms of headache and vomiting.
- Radiological imaging revealed a contrast-enhancing lesion with calcifications in the right temporoparietal cortex.
Findings:
- Histopathological examination initially suggested gliosarcoma or teratoma with malignant transformation.
- Immunohistochemical analysis confirmed the diagnosis of gliosarcoma with fibrosarcomatous differentiation.
Implications:
- This case underscores the extreme rarity of primary gliosarcoma in children.
- The diagnosis and management of pediatric gliosarcoma present unique challenges due to its rarity and poor prognosis.
Abstract:
Gliosarcoma is a rare variant of glioblastoma with a biphasic pattern showing glial and mesenchymal differentiation. It is seen in adults during their fifth to sixth decades of life and is extremely rare in children. We report a case of primary gliosarcoma with fibrosarcomatous differentiation in an 11-year-old boy presenting with headache and vomiting. Imaging showed a contrast-enhancing isodense space-occupying lesion with areas of calcification in the right temporoparietal cortex. A total excision was done and, on histopathologic examination, a differential diagnostic consideration of gliosarcoma and teratoma with malignant transformation was made. After immunohistochemical analysis, a final diagnosis of gliosarcoma with fibrosarcomatous differentiation was then made. Primary gliosarcoma is a very rare tumor in children with a poor prognosis.
