Secondary gliosarcoma transformed from lower grade glioma: one case report

Abstract

Objective A case of secondary gliosarcoma transformed from lower grade glioma was analyzed. The clinicopathological features, molecular pathological features and prognosis of secondary gliosarcoma were discussed with relevant literatures. Methods and Results A 42⁃year⁃old female patient was admitted to our hospital. CT showed occupying lesion in left frontal lobe. The first surgery was performed and the initial pathological diagnosis was oligodendroglioma (WHO Ⅱ grade). Nineteen months after the first surgery, the tumor recurred, and the second surgery and chemotherapy were performed. The post⁃operative pathological diagnosis was glioblastoma (WHOⅣgrade). Twenty⁃two months after the second surgery, the tumor recurred again. Then the third surgery was performed and the pathological diagnosis was gliosarcoma (WHOⅣgrade). Radiotherapy and chemotherapy were given after operation. The patient died 14 months after the third surgery. Conclusions According to the 2016 WHO classification, gliosarcoma, classified as a subtype of glioblastoma, was a WHO grade Ⅳ tumor. As of now, the treatment paradigms for gliosarcoma were similar to that of gliosarcoma, including maximal safe resection, post ⁃ operative radiotherapy and concurrent and adjuvant chemotherapy. IDH1 mutation and MGMT promoter methylation had certain predictive value for the prognosis.

DOI：10.3969/j.issn.1672⁃6731.2019.12.009