February 16, 2015
A previously healthy 54-year-old woman presents after a motor vehicle accident for evaluation of altered mental status
Gliosarcoma
- Gliosarcoma (GSM) is a rare primary CNS neoplasm with reported incidence of 1–8% of all the malignant gliomas. This is a highly vascular tumour exhibiting marked tumor angiogenesis and slight temporal lobes preponderance.
- Secondary gliosarcoma refers to sarcomatous change in a pre-existent or partially resected/treated glioma.
- No significant differences are seen with GSM and glioblastoma.
- GSM can invade meninges and bone. It can metastasize to other body parts.
- Key Diagnostic Features: GSM is known to present with lobar hemorrhage and can mimic a vascular malformation. If an angiogram is obtained, network of blood vessels and early venous shunting is seen. The extensive vascular nature of the lesion results in increased perfusion. Otherwise, on conventional imaging, the lesion can look similar to glioblastoma. The pathologist remains the final arbiter.
- DDx: Glioblastoma, metastasis
- Rx: Surgical excision/debulking and radiation-chemotherapy
- Prognosis: Very poor
April 2014
A 58-year-old woman with sudden onset headache, right-sided weakness, and altered sensorium. No significant prior medical or surgical history.
