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Gliosarcoma with unusual glial components: Two case reports.

Yusuke Otsu1, Yoshihisa Matsumoto1, Koichi Higaki2

  • 1Department of Neurosurgery, St Mary's Hospital, Fukuoka, Japan.

Neuropathology : Official Journal of the Japanese Society of Neuropathology
|June 1, 2022
PubMed
Summary
This summary is machine-generated.

This study reports two gliosarcoma cases, highlighting the importance of evaluating glial components. Further genetic analysis is needed for better understanding and treatment of this rare brain tumor.

Keywords:
TERT mutationgiant cell glioblastomaglial componentgliosarcomapleomorphic xanthoastrocytoma

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Area of Science:

  • Neuro-oncology
  • Pathology
  • Genetics

Background:

  • Gliosarcoma is a rare brain tumor defined by both glial and mesenchymal elements.
  • While mesenchymal components are well-documented, glial components are less frequently reported, posing diagnostic challenges.

Observation:

  • Two gliosarcoma cases are presented, detailing clinical presentations, MRI findings, and histopathological analyses.
  • Case 1 featured a glial component resembling pleomorphic xanthoastrocytoma, with a favorable 12-month post-treatment outcome.
  • Case 2 exhibited a glial component with large cells, a higher Ki-67 index than the mesenchymal part, and a TERT gene mutation, but recurred and progressed despite treatment.

Findings:

  • Histopathological evaluation revealed distinct glial components in both gliosarcoma cases, one mimicking pleomorphic xanthoastrocytoma and the other showing aggressive features with a TERT mutation.
  • Genetic analysis identified a TERT mutation in one case, which was lost upon recurrence, suggesting potential genetic evolution of the tumor.
  • The Ki-67 proliferation index was higher in the glial component compared to the mesenchymal component in Case 2.

Implications:

  • Detailed histopathological assessment of glial components is crucial for accurate gliosarcoma diagnosis and prognosis.
  • Further molecular and genetic investigations are necessary to elucidate the pathogenesis and identify therapeutic targets for gliosarcoma.
  • Understanding the heterogeneity and potential genetic alterations in gliosarcoma may lead to improved treatment strategies and patient outcomes.