Primary Gliosarcoma: A 15-Year Experience at a Tertiary Care Center

Gliosarcomas (GSM) are rare intracranial tumors composed of both glial and mesenchymal components. Given the rarity of the condition, there is limited literature on their clinical, radiological, pathological features, and treatment modalities.

Histopathologically confirmed cases of gliosarcomas were retrospectively analyzed. Based on the intraoperative macroscopic descriptions, patients were subdivided into two groups: tumors resembling meningioma and tumors resembling glioblastoma. Clinicoradiological presentations, characteristic pathological features, therapeutic modalities, and the survival of patients with gliosarcoma were analyzed.

Twenty-five patients (17 males and 8 females) were retrospectively analyzed in this study. The mean age of presentation was 45.8 + 11.7 years, while the mean duration of symptoms was 2 months. The most common site of the tumor was frontal lobe. All the patients underwent maximal safe resections. Postoperative radiotherapy was received by all 25 patients. Sixteen patients received concurrent and adjuvant chemotherapy with temozolomide.The median survival was 11 months (range: 4-42 months). Patients with tumors mimicking a meningioma (intraoperatively) had better survival than patients with glioblastoma-like features (P < 0.01).

Our study supports the presence of two distinct types of GSM: one which is similar to glioblastoma multiforme and another which resembles more of meningioma. Good surgical excision is a favorable prognostic factor for the outcome of GSM. Gliosarcoma which resembles meningioma has got better survival outcome compared to the one that resembles glioblastoma.