Secondary gliosarcoma transformed from lower grade glioma: one case report

doi:10.3969/j.issn.1672-6731.2019.12.009

Abstract

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 (WHOⅣ grade). Twenty-two months after the second surgery, the tumor recurred again. Then the third surgery was performed and the pathological diagnosis was gliosarcoma (WHOⅣ grade). 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.

Key words: Glioma, Sarcoma, Neoplasms, second primary, Pathology

摘要：

目的介绍1例继发于低级别胶质瘤的继发性胶质肉瘤患者的治疗原则，总结胶质肉瘤的组织病理学和分子病理学特征及预后。方法与结果 女性患者，42岁，头部CT显示左侧额叶占位性病变，首次手术切除，术后病理诊断为少突胶质细胞瘤（WHOⅡ级）；术后19个月肿瘤复发，第2次手术切除，术后病理诊断为胶质母细胞瘤（WHOⅣ级），术后辅助替莫唑胺化疗；第2次术后22个月肿瘤再次复发，第3次手术切除，术后病理诊断为胶质肉瘤（WHOⅣ级），术后辅助放射治疗和替莫唑胺同步化疗；第3次术后14个月死亡。结论针对胶质肉瘤的治疗方案与胶质母细胞瘤相似，应最大程度手术安全切除，术后辅助放射治疗和同步药物化疗；IDH1基因突变和MGMT启动子区甲基化对预后具有重要预测意义。

关键词: 神经胶质瘤, 肉瘤, 肿瘤, 继发原发性, 病理学

GUO Wei, LIU Jing-hui, JI Pei-gang, LOU Miao, ZHAI Yu-long, GAO Guo-dong, QU Yan, WANG Liang. Secondary gliosarcoma transformed from lower grade glioma: one case report[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2019, 19(12): 958-963.

郭为, 刘竞辉, 冀培刚, 娄淼, 翟玉龙, 高国栋, 屈延, 王樑. 继发于低级别胶质瘤的继发性胶质肉瘤一例[J]. 中国现代神经疾病杂志, 2019, 19(12): 958-963.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2019.12.009

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