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Related Experiment Videos

Unusual evolution and computerized tomographic appearance of a gliosarcoma

M C Preul1, J A Espinosa, D Tampieri

  • 1Division of Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, PQ, Canada.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|May 1, 1994
PubMed
Summary

A rare brain tumor, gliosarcoma, mimicked a stroke on CT scans for years. Post-mortem examination revealed the tumor

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Area of Science:

  • Neuropathology
  • Neuroradiology
  • Oncology

Background:

  • A patient presented with neurological deficits including seizures and hemiparesis.
  • Long-term computerized tomography (CT) imaging revealed a stable, large, wedge-shaped hypodensity in the left hemisphere, initially interpreted as a remote infarct.
  • The lesion showed a central calcification but lacked mass effect, presenting an atypical imaging pattern.

Observation:

  • A patient with a remote infarct, seizures, hemiparesis, and dysphasia experienced a four-month decline in neurological function.
  • Serial computed tomography (CT) scans over five years revealed a persistent, large, wedge-shaped left hemisphere hypodensity with central calcification, interpreted as a left middle cerebral artery infarct.
  • The lesion showed no signs of mass effect despite its size.

Findings:

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  • Post-mortem neuropathological examination identified the entire area previously interpreted as an infarct to be a gliosarcoma.
  • The unusual CT appearance, lacking mass effect, is hypothesized to result from a low-grade glioma transforming into a gliosarcoma that infiltrated the infarct encephalomalacia.
  • The patient's rapid deterioration correlated with the suspected tumor transformation into gliosarcoma.

Implications:

  • This case highlights the potential for gliosarcomas to present atypically on CT, mimicking chronic infarcts.
  • Understanding the variable CT characteristics of gliosarcomas is crucial for accurate diagnosis and treatment planning.
  • Further research into the imaging features and biological behavior of gliosarcomas in specific contexts, like post-infarctional areas, is warranted.