Diagnosis and treatment of gliosarcoma: a report of 15 cases and literature review

ZHANG Zhi-yuan; WANG Han-dong; FAN You-wu; JIA Yue; WU Jin-rong

doi:10.13798/j.issn.1009-153X.2018.02.002

Abstract：Objective To investigate the diagnosis and treatment of gliosarcomas.Methods The clinical data of patients with gliosarcomas which were pathologically confirmed were analyzed retrospectively.Results The main clinical symptoms were high intracranial pressure and local dysfunctions.Two patients had extracranial metastases.Imaging features:all the tumors were in the cerebral cortex;most of them were similar to glioblastomas without clear border in the findings on the imaging;the parts of gliosarcomas were similar to the meningiomas in the fingdings on the imaging,which were significantly enhanced,and closely related to the dura and skull.Gliosarcoma,in which the cells were pathologically polyomorphic,mainly consisted of both the glioblastoma and gliosarcoma cells,and had immunohistochemically positive glial fibrillary acidic protein.Of 15 patients with gliosarcomas,10 received total resection of the tumors,3 subtotal and 2 parts.Of 12 patients who were followed up from 6 months to 8 years,10 had the tumorous recurrence and 2 not.Eight patients died during the following-up.Conclusions Gliosarcoma,which is one of most malignant gliomas,tends to invade the meninges and skull,and easily metastasizes extracranially.The diagnosis of gliosarcoma depends on the histopathological examination.Surgical resection is the main method to treat gliosarcoma.Postoperative radiotherapy and chemotherapy can improve the prognoses in the patients with gliosarcomas.The prognosis is worse in the patients with gliosarcomas than that in the patients with glioblastomas.