Skip to main content

Advertisement

SpringerLink
Log in

Sarcoma arising as a distinct nodule within glioblastoma: a morphological and molecular perspective on gliosarcoma

  • Clinical Study – Patient Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Gliosarcoma is a variant of glioblastoma and is characterized by distinct glial and sarcomatous components. Typically, there is no macroscopic boundary between the components and special stains are often required to distinguish the glial and sarcomatous elements. Some studies suggest similar genetic alterations in both components pointing to a common origin. We present an extreme case of gliosarcoma arising as a discrete fibrous nodule adjacent to a typical glioblastoma. A 65 year-old woman presented with progressive weakness, seizures and right-sided hemiparesis. CT scan demonstrated an irregular enhancing left frontal lobe mass and an adjacent discrete nodule with different imaging characteristics. The unique nature of this macroscopically biphasic neoplasm allowed us to compare the molecular characteristics of glial and sarcomatous elements which were strikingly similar except for small losses and gains in Chr 3. Studies are under way to determine the significance of chromosome 3 alterations in gliosarcomas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Feigin IH, Gross SW (1955) Sarcoma arising in glioblastoma of the brain. Am J Pathol 31:633–653

    PubMed  CAS  Google Scholar 

  2. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97–109. doi:10.1007/s00401-007-0243-4

    Article  PubMed  Google Scholar 

  3. Lutterbach J, Guttenberger R, Pagenstecher A (2001) Gliosarcoma: a clinical study. Radiother Oncol 61:57–64

    Article  PubMed  CAS  Google Scholar 

  4. Galanis E, Buckner JC, Dinapoli RP, Scheithauer BW, Jenkins RB, Wang CH, O’Fallon JR, Farr G Jr (1998) Clinical outcome of gliosarcoma compared with glioblastoma multiforme: North Central Cancer Treatment Group results. J Neurosurg 89:425–430. doi:10.3171/jns.1998.89.3.0425

    Article  PubMed  CAS  Google Scholar 

  5. Monzon FA, Alvarez K, Gatalica Z, Bridge JA, Nelson M, Kim HJ, Hagenkord JM (2009) Detection of chromosomal aberrations in renal tumors: a comparative study of conventional cytogenetics and virtual karyotyping with single-nucleotide polymorphism microarrays. Arch Pathol Lab Med 133:1917–1922

    PubMed  Google Scholar 

  6. Miller CR, Perry A (2007) Glioblastoma. Arch Pathol Lab Med 131:397–406

    PubMed  Google Scholar 

  7. Meis JM, Ho KL, Nelson JS (1990) Gliosarcoma: a histologic and immunohistochemical reaffirmation. Mod Pathol 3:19–24

    PubMed  CAS  Google Scholar 

  8. Jones H, Steart PV, Weller RO (1991) Spindle-cell glioblastoma or gliosarcoma? Neuropathol Appl Neurobiol 17:177–187

    Article  PubMed  CAS  Google Scholar 

  9. Actor B, Cobbers JM, Buschges R, Wolter M, Knobbe CB, Lichter P, Reifenberger G, Weber RG (2002) Comprehensive analysis of genomic alterations in gliosarcoma and its two tissue components. Genes Chromosomes Cancer 34:416–427. doi:10.1002/gcc.10087

    Article  PubMed  CAS  Google Scholar 

  10. Reis RM, Konu-Lebleblicioglu D, Lopes JM, Kleihues P, Ohgaki H (2000) Genetic profile of gliosarcomas. Am J Pathol 156:425–432

    Article  PubMed  CAS  Google Scholar 

  11. McComb RD, Jones TR, Pizzo SV, Bigner DD (1982) Localization of factor VIII/von Willebrand factor and glial fibrillary acidic protein in the hemangioblastoma: implications for stromal cell histogenesis. Acta Neuropathol 56:207–213

    Article  PubMed  CAS  Google Scholar 

  12. Kochi N, Budka H (1987) Contribution of histiocytic cells to sarcomatous development of the gliosarcoma. An immunohistochemical study. Acta Neuropathol 73:124–130

    Article  PubMed  CAS  Google Scholar 

  13. Grant JW, Steart PV, Aguzzi A, Jones DB, Gallagher PJ (1989) Gliosarcoma: an immunohistochemical study. Acta Neuropathol 79:305–309

    Article  PubMed  CAS  Google Scholar 

  14. Han SJ, Yang I, Tihan T, Chang SM, Parsa AT (2010) Secondary gliosarcoma: a review of clinical features and pathological diagnosis. J Neurosurg 112:26–32. doi:10.3171/2009.3.JNS081081

    Article  PubMed  Google Scholar 

  15. Biernat W, Aguzzi A, Sure U, Grant JW, Kleihues P, Hegi ME (1995) Identical mutations of the p53 tumor suppressor gene in the gliomatous and the sarcomatous components of gliosarcomas suggest a common origin from glial cells. J Neuropathol Exp Neurol 54:651–656

    Article  PubMed  CAS  Google Scholar 

  16. Boerman RH, Anderl K, Herath J, Borell T, Johnson N, Schaeffer-Klein J, Kirchhof A, Raap AK, Scheithauer BW, Jenkins RB (1996) The glial and mesenchymal elements of gliosarcomas share similar genetic alterations. J Neuropathol Exp Neurol 55:973–981

    Article  PubMed  CAS  Google Scholar 

  17. Creighton CJ, Chang JC, Rosen JM (2010) Epithelial-mesenchymal transition (EMT) in tumor-initiating cells and its clinical implications in breast cancer. J Mammary Gland Biol Neoplasia 15:253–260. doi:10.1007/s10911-010-9173-1

    Article  PubMed  Google Scholar 

  18. Taube JH, Herschkowitz JI, Komurov K, Zhou AY, Gupta S, Yang J, Hartwell K, Onder TT, Gupta PB, Evans KW, Hollier BG, Ram PT, Lander ES, Rosen JM, Weinberg RA, Mani SA (2010) Core epithelial-to-mesenchymal transition interactome gene-expression signature is associated with claudin-low and metaplastic breast cancer subtypes. Proc Natl Acad Sci USA 107:15449–15454. doi:10.1073/pnas.1004900107

    Article  PubMed  CAS  Google Scholar 

  19. Vincent T, Neve EP, Johnson JR, Kukalev A, Rojo F, Albanell J, Pietras K, Virtanen I, Philipson L, Leopold PL, Crystal RG, de Herreros AG, Moustakas A, Pettersson RF, Fuxe J (2009) A SNAIL1-SMAD3/4 transcriptional repressor complex promotes TGF-beta mediated epithelial-mesenchymal transition. Nat Cell Biol 11:943–950. doi:10.1038/ncb1905

    Article  PubMed  CAS  Google Scholar 

  20. Batlle E, Sancho E, Franci C, Dominguez D, Monfar M, Baulida J, Garcia De Herreros A (2000) The transcription factor snail is a repressor of E-cadherin gene expression in epithelial tumour cells. Nat Cell Biol 2:84–89. doi:10.1038/35000034

    Article  PubMed  CAS  Google Scholar 

  21. Nieto MA (2002) The snail superfamily of zinc-finger transcription factors. Nat Rev Mol Cell Biol 3:155–166. doi:10.1038/nrm757

    Article  PubMed  CAS  Google Scholar 

  22. Martinez-Estrada OM, Culleres A, Soriano FX, Peinado H, Bolos V, Martinez FO, Reina M, Cano A, Fabre M, Vilaro S (2006) The transcription factors Slug and Snail act as repressors of Claudin-1 expression in epithelial cells. Biochem J 394:449–457. doi:10.1042/BJ20050591

    Article  PubMed  CAS  Google Scholar 

  23. Ioannou M, Papagelopoulos PJ, Papanastassiou I, Iakovidou I, Kottakis S, Demertzis N (2008) Detection of somatostatin receptors in human osteosarcoma. World J Surg Oncol 6:99. doi:10.1186/1477-7819-6-99

    Article  PubMed  Google Scholar 

  24. Ferrari S, Dondi M, Fanti S, Zoboli S, Giacomini S, Mercuri M, Bacci G (2003) Somatostatin receptor (SSTR) scintigraphy in patients with osteosarcoma. Cancer Biother Radiopharm 18:847–851. doi:10.1089/108497803770418391

    Article  PubMed  CAS  Google Scholar 

  25. Ellis P, Fagan BM, Magness ST, Hutton S, Taranova O, Hayashi S, McMahon A, Rao M, Pevny L (2004) SOX2, a persistent marker for multipotential neural stem cells derived from embryonic stem cells, the embryo or the adult. Dev Neurosci 26:148–165. doi:10.1159/000082134

    Article  PubMed  CAS  Google Scholar 

  26. Han SJ, Yang I, Tihan T, Chang SM, Parsa AT (2010) Secondary gliosarcoma: a review of clinical features and pathological diagnosis. J Neurosurg 112:26–32. doi:10.3171/2009.3.JNS081081

    Article  PubMed  Google Scholar 

  27. Han SJ, Yang I, Ahn BJ, Otero JJ, Tihan T, McDermott MW, Berger MS, Prados MD, Parsa AT (2010) Clinical characteristics and outcomes for a modern series of primary gliosarcoma patients. Cancer 116:1358–1366. doi:10.1002/cncr.24857

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

We are deeply grateful to Dr. Shera Kash, PhD from the Molecular Pathology and Clinical Genomics Division of the Department of Pathology and Creighton Medical Labs for her expert contribution and the analysis of the 250 K Affymetrix NspI single nucleotide polymorphism (SNP) arrays.

Author information

Authors and Affiliations

  1. Department of Pathology, Neuropathology Unit, University of California at San Francisco, Room M551, 505 Parnassus Avenue, San Francisco, CA, 94143-0102, USA

    Cynthia Jimenez, Martin Powers & Tarik Tihan

  2. Department of Radiology, University of California at San Francisco, 505 Parnassus Avenue, Box 0628, San Francisco, CA, 94143-0102, USA

    Christine Glastonbury

  3. Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA

    Andrew T. Parsa

  4. Department of Pathology, iKaryos Diagnostics, Creighton University Medical Laboratories, Omaha, NE, USA

    Jill M. Hagenkord

Authors
  1. Cynthia Jimenez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Powers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrew T. Parsa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christine Glastonbury
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jill M. Hagenkord
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tarik Tihan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tarik Tihan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jimenez, C., Powers, M., Parsa, A.T. et al. Sarcoma arising as a distinct nodule within glioblastoma: a morphological and molecular perspective on gliosarcoma. J Neurooncol 105, 317–323 (2011). https://doi.org/10.1007/s11060-011-0593-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-011-0593-6

Keywords

Search

Navigation