A rare case presentation with histopathology challenges: Gliosarcoma

Abstract

Gliosarcoma (GSM) is a high-grade variant of glioblastoma (GBM) characterised by a biphasic tissue pattern with alternating areas displaying glial and mesenchymal differentiation. The glial component fulfils World Health Organisation grade 4 astrocytoma criteria. It is rare, with an incidence of 0.86% among adults with brain tumours. GSM affects adult mainly in the fourth to sixth decades of life, with male predominance and rarely occurs in children, even in the very young. The clinical and radiologic presentations resemble glioblastoma, with a median survival of 9 months and progressive symptoms. Neuroimaging in cases with a predominant sarcomatous component may mimic a meningioma has been reported to indicate prolonged survival compared to a case with a predominant glioblastoma component. Hence, the discordance between clinical, radiological, intraoperative and histopathological findings is a challenge in establishing a diagnosis of gliosarcoma.