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Query: UMLS:C0017636 (glioblastoma)
 18,345 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors review the clinical and pathological features of 24 patients with gliosarcoma. The study revealed the following findings. Gliosarcoma occurs more frequently than is indicated in the literature, and in our series was present in 8% of all cases of glioblastoma multiforme. The presenting features are not significantly different from those of glioblastoma multiforme. The lesion often presents itself at surgery as a firm, well circumscribed mass within the temporal lobe, and at surgery it is commonly mistaken for a meningioma. There is an increased likelihood of metastasis compared to that of glioblastoma. The prognosis is no worse than that of glioblastoma, in spite of the addition of sarcomatous elements.
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PMID:Clinical and pathological study of 24 cases of gliosarcoma. 95 76

Twenty-five neonatal beagles were used for this study. Gliosarcoma was injected into the cerebral hemisphere of 7 neonatal beagles (Group I). These animals were then treated by boron neutron capture therapy. The response of the tumor to therapy was evaluated by serial CT scans and 3 times magnification of cerebral angiography. The animals were sacrificed at varying post-therapy periods for histological study. Fifteen neonatal beagles implanted gliosarcoma without therapy (Group II) and 3 normal controls without tumor (Group III) were subjected to the same follow-up studies. (Results) (1) Neonatal beagles with implanted tumor showed moderate degree of ventricular dilatation within a short period. The finding of communicating hydrocephalus was interpreted as initial growth of tumor. (2) Animals after therapy had variable cavitation in the hemisphere that had contained calcium deposit on CT. Moderate dilatation of the lateral ventricle was present without any significant midline shift and there was an area of porencephaly extending out from the right lateral ventricle on CT (Fig. 1, Case 2). Cerebral angiography demonstrated hydrocephalus with an avascular region in the right cerebral hemisphere, compatible with the previously described porencephalic cyst (Fig. 2, Case 2). (3) Three cases out of 7 showed neurological symptoms after tumor implantation (Cases 3, 5 and 6). Carotid angiography showed large temporal lobe tumor with some tumor stain and also some involvement of the right frontal lobe after therapy (Fig. 7, Case 3). In postmortem examination, there was tumor seen coating the right lateral ventricle as well as the left temporal horn. The right cerebral hemisphere was slightly smaller than the left. The left lateral ventricle was remarkably enlarged (Fig. 9). (4) Four out of 7 treated animals with injected gliosarcoma showed no evidence of tumor at postmortem examination. CT demonstrated moderate dilatation of the lateral ventricle without any significant midline shift, an area of porencephaly and definite decrease in size of the right cerebral hemisphere and calvarium (Fig. 4). (5) Fifteen neonatal beagles implanted gliosarcoma without therapy (Group II) developed symptomatic and died within two weeks. (6) Control animals showed no ventricular dilatation or other abnormalities. (7) Microscopic examinations showed no similarities between implanted gliosarcoma and human glioblastoma. (Conclusion) Serial CT scans and magnification cerebral angiography in this experimental model appear extremely helpful in following the effects of therapy and important tool for the evaluation of a tumor growth or regression.
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PMID:[Neuroradiological Evaluation of an experimentally implanted tumor into cerebral hemisphere of neonatal beagles (author's transl)]. 709 78

Gliosarcoma is a rare tumor of the central nervous system, consisting of gliomatous and sarcomatous elements. We present an unusual case of gliosarcoma which demonstrated a variation in phenotype over a six month period, changing from a gliosarcoma with osteosarcomatous differentiation, to a gliosarcoma with no osteosarcomatous component. The initial histological diagnosis was glioblastoma multiforme. Fifteen months later the tumor had transformed into a gliosarcoma demonstrating osteosarcomatous differentiation, with the majority of the tumor consisting of osteoid matrix. Further samples taken six months later revealed gliosarcoma with almost no osteosarcomatous component. It is recognized that glioblastoma can undergo a change in phenotype, transforming into a gliosarcoma. This case demonstrates that ongoing changes in phenotype can occur, especially when the tumor has been treated with chemotherapy and radiotherapy. An understanding of the pathological progression of gliosarcoma will become increasingly important as novel treatments for gliosarcoma and glioblastoma become available.
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PMID:Gliosarcoma with osteosarcomatous differentiation: review of radiological and pathological features. 1526 Dec 43

Gliosarcoma, a rare pathological entity composed of 2-8% malignant gliomas, is characterized by a biphasic tissue pattern with alternating areas displaying glial and mesenchymal differentiation. Here we report the preferential recurrence of a sarcomatous component in gliosarcoma after boron neutron capture therapy (BNCT), while a gliomatous component disappeared as a result of the treatment. A 56-year-old woman with a left frontal tumor was introduced to our clinic. After stereotactic biopsy, craniotomy was applied and 90% of the mass was resected. The histological diagnosis was glioblastoma with small amounts of sarcomatous component, that is, gliosarcoma. BNCT was applied 30 days after craniotomy. Two weeks after BNCT, almost all of the contrast-enhanced mass had disappeared on magnetic resonance images; however, a half year later, the mass recurred just below the original site and extended posteriorly. Irrespective of repetitive salvage surgeries, the patient died of the recurrent tumor. At autopsy, tumor cells of the frontal lobe were absent. A well-circumscribed mass of the parietal and occipital lobes was composed of sarcomatous material, with very little glial fibrillary acid protein-positive glial material. We found in this patient the preferential recurrence of the sarcomatous component of a gliosarcoma after potent radiotherapeutics in the form of BNCT.
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PMID:Preferential recurrence of a sarcomatous component of a gliosarcoma after boron neutron capture therapy: case report. 1623 87

Gliosarcoma is a highly malignant brain tumor consisting of both a glioblastoma and a mesenchymal component. The latter typically resembles fibrosarcoma, but differentiation patterns resembling osteosarcoma, chondrosarcoma, angiosarcoma and rhabdomyosarcoma have also been described. Molecular-genetic studies have shown that both glioblastoma and the mesenchymal component share identical cytogenetic abnormalities or mutations, suggesting a monoclonal origin from glial cells. We report an unusual case of gliosarcoma that presented as a large intracerebral tumor with infiltration of the temporal bone and the soft tissues in the infratemporal fossa. Microscopically, the tumor consisted of alternating areas of glioblastoma and fibrosarcoma. Focally, areas ofosteosarcomatous and liposarcomatous differentiation were found. Although gliosarcoma with transcranial penetration is very rare, it should be suspected in case of intracranial tumor with glioblastoma-imaging features, infiltration of bone and extracranial growth. Our case of liposarcomatous differentiation in gliosarcoma--together with another very recently reported similar case--expands the morphologic heterogeneity of this peculiar brain tumor.
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PMID:Gliosarcoma with liposarcomatous component, bone infiltration and extracranial growth. 1686 2

Gliosarcoma is a rare malignant neoplasm of the central nervous system with a propensity for metastasis. There are fewer than 20 reported cases of extracranial metastases of gliosarcoma with the majority of cases reflecting a tendency for hematogenous dissemination. Here we describe the case of a 47-year-old man who developed pervasive extracranial metastases from a temporal gliosarcoma following radio- and chemotherapy for a primary glioblastoma. The patient initially presented with progressively worsening headaches, left-sided weakness and numbness associated with right temporo-parietal mass for which he underwent craniotomy with stereotactic gross-total excision. Two months postoperatively, interstitial brachytherapy and external beam radiotherapy were initiated. The patient initially declined chemotherapy. The tumor recurred twice and the patient underwent re-operation and multiple courses of chemotherapy; histopathological diagnosis remained glioblastoma multiforme. Nineteen months following initial resection the patient's clinical status deteriorated and CT scan demonstrated multiple intrathoracic, hepatic and splenic lesions. Postmortem examination revealed widespread, infiltrating gliosarcoma with intravascular gliomatosis and extensive visceral metastases. This is the first report of pervasive extracranial metastases to numerous sites, several of which have not been previously reported. The histogenesis and the potential role of therapeutic irradiation in the development of gliosarcoma are briefly reviewed.
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PMID:Gliosarcoma with multiple extracranial metastases: case report and review of the literature. 1717 42

Gliosarcoma is an uncommon variant of glioblastoma characterized by a biphasic pattern of glial and mesenchymal differentiation in the tumor. These tumors occur mostly in the cerebral hemispheres. Intraventricular location is extremely rare. Extensive review of literature revealed only two cases of intraventricular gliosarcoma. The first case arose by malignant transformation of a preexisting ependymoma. The second case was a gliosarcoma involving the frontal lobe with extension into the lateral ventricle. We report a case of an exclusively lateral ventricular tumor probably arising from the interventricular septum and blocking the CSF pathway. To the best of our knowledge, this is the first reported case of an exclusively intraventricular gliosarcoma.
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PMID:An unusual case of intraventricular gliosarcoma. 1978 54

Gliosarcoma (GS) is a glioblastoma with a sarcomatous component that is presumed to be a metaplastic differentiation of glioma cells. We studied the clinical relevance of this histological glioblastoma subentity within the pediatric population. We obtained patient data from the German HIT-GBM database, which contains clinical data for more than 600 pediatric patients with centrally reviewed high-grade gliomas. By applying defined inclusion criteria (diagnosis of GS proven by central neuropathological review; patient age 0 to 21 years), four patients were identified. In addition, after a review of the English medical scientific literature, 19 additional cases were found. The relative frequency of GS in the German HIT-GBM database was only 1.9%. In the whole series of 23 pediatric GS patients, including previously reported cases, the male-to-female-ratio was 1.2:1. GS was found in all pediatric age groups with a median age of 11 years, but there was an unexpectedly high accumulation in infants (6 of 23 <3 years of age, 26%). GS showed a strong predilection of the cerebral hemispheres (22 out of 23 cases). Increased intracranial pressure was the leading symptom of a short clinical history with a median duration of 0.7 month. Interestingly, six patients (26%) were reported with a history of cranial radiotherapy prior to GS diagnosis. In 60% of the GS patients in our series, gross total resection was achieved. Median overall (OS) and event-free survivals (EFS) of the total cohort were 12.1 and 9.8 months, respectively. In conclusion, GS is a very rare tumor entity in children. Literature review suggests a relatively higher incidence in infants and in patients with a previous history of radiotherapy.
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PMID:Clinical and epidemiological characteristics of pediatric gliosarcomas. 1980 21

Congenital brain tumors are rare. Clinically, they often result in macrocrania, hydrocephalus, and focal neurologic deficits. Fetal onset may result in dystocia and stillbirth. Antenatal detection is becoming more common as the result of neuroimaging, and modalities such as magnetic resonance imaging can assist in narrowing the pathologic differential diagnoses. Teratomas and astrocytomas appear to be the most common congenital neoplasms. Amongst the latter, all grades and many subtypes are represented in the congenital time period, including the diffusely infiltrative forms of astrocytoma. Gliosarcoma is currently considered a variant of glioblastoma (i.e., astrocytoma, World Health Organization grade IV) that exhibits genetically similar yet phenotypically separate histologic regions of high-grade astrocytoma and sarcoma. Only rare instances of congenital gliosarcoma have been reported. We detail the case of a 1-day-old term male who presented with macrocrania, hydrocephalus, and signs of increased intracranial pressure. Pathology revealed evidence of a classic gliosarcoma.
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PMID:Congenital gliosarcoma: detailed clinicopathologic documentation of a rare neoplasm. 1988 37

Cancer stem cells (CSCs) are characterized by their self-renewing potential and by their ability to differentiate and phenocopy the original tumor in orthotopic xenografts. Long-term propagation of glioblastoma (GBM) cells in serum-containing medium results in loss of the CSCs and outgrowth of cells genetically and biologically divergent from the parental tumors. In contrast, the use of a neurosphere assay, a serum-free culture for selection, and propagation of central nervous system-derived stem cells allows the selection of a subpopulation containing CSCs. Gliosarcoma (GS), a morphological variant comprising approximately 2% of GBMs, present a biphasic growth pattern, composed of glial and metaplastic mesenchymal components. To assess whether the neurosphere assay would allow the amplification of a subpopulation of cells with "gliosarcoma stem cell" properties, capable of propagating both components of this malignancy, we have generated neurospheres and serum cultures from primary GS and GBM surgical specimens. Neurosphere cultures from GBM and GS samples expressed neural stem cell markers Sox2, Musashi1, and Nestin. In contrast to the GBM neurosphere lines, the GS neurospheres were negative for the stem cell marker CD133. All neurosphere lines generated high-grade invasive orthotopic tumor xenografts, with histological features strikingly similar to the parental tumors, demonstrating that these cultures indeed are enriched in CSCs. Remarkably, low-passage GS serum cultures retained the expression of stem cell markers, the ability to form neurospheres, and tumorigenicity. The GS experimental tumors phenocopied the parental tumor, exhibiting biphasic glial and mesenchymal components, constituting a clinically relevant model to investigate mesenchymal differentiation in GBMs.
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PMID:Gliosarcoma stem cells undergo glial and mesenchymal differentiation in vivo. 1993 55


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