[A Patient with Primary Intraventricular Gliosarcoma and Long-term Survival - a Case Report]

Area of Science:

• Neuro-oncology
• Neurosurgery
• Medical Oncology

Background:

• Gliosarcoma, a rare and aggressive central nervous system (CNS) tumor, is a variant of glioblastoma multiforme with both glial and mesenchymal components.
• Established treatment strategies for gliosarcoma remain unclear, contributing to its poor prognosis.
• This report focuses on a challenging case of gliosarcoma with unfavorable clinical-pathological features.

Observation:

• A 23-year-old female presented with symptoms including headaches, nausea, vomiting, and left arm motor weakness.
• Brain MRI revealed a tumor in the right lateral ventricle extending into the right frontal lobe.
• The patient underwent multiple surgeries, chemoradiotherapy with temozolomide (Stupp regimen), and salvage chemotherapy (ICE regimen) due to tumor recurrence and progression.

Findings:

• Histological examination confirmed gliosarcoma in initial and subsequent resections.
• Despite initial progression and recurrence at 8 and 28 months post-diagnosis, the patient achieved long-term survival.
• The multimodal treatment approach, including maximal resection and salvage chemotherapy, resulted in a stable condition for 31 months post-diagnosis.

Implications:

• This case demonstrates that long-term survival is achievable in gliosarcoma patients, even with unfavorable prognostic factors.
• Maximal surgical resection followed by adjuvant radiotherapy and tailored chemotherapy regimens are crucial for managing gliosarcoma.
• The study highlights the potential of exploring less common chemotherapy regimens for recurrent or refractory gliosarcoma.