Brain Tumor Pathology

, Volume 31, Issue 1, pp 40–46 | Cite as

Genetic and pathologic evolution of early secondary gliosarcoma

  • Kari-Elise T. Codispoti
  • Stacy Mosier
  • Robert Ramsey
  • Ming-Tseh Lin
  • Fausto J. Rodriguez
Case Report

Abstract

Gliosarcoma is a subset of glioblastoma with glial and mesenchymal components. True secondary gliosarcomas (i.e. progressing from lower-grade precursors) in the absence of radiation therapy are very rare. We report the unique case of a 61-year-old male who developed a fibrillary astrocytoma (WHO grade II). In the absence of adjuvant therapy the tumor recurred 3 years later as a gliosarcoma comprising an infiltrating glial component and a curious, early high-grade sarcomatous component surrounding intratumoral vessels. DNA was extracted from formalin fixed paraffin-embedded tissues from the precursor low-grade glioma and from the glioma and sarcomatous components at progression. Samples were hybridized separately to a 300 k Illumina SNP array. IDH1(R132H) mutant protein immunohistochemistry was positive in all tissue components. Alterations identified in all samples included dup(1)(q21q41), del(1)(q41qter), del(2)(q31.1), del(2)(q36.3qter), del(4)(q35.1qter), dup(7)(q22.2q36.3), del(7)(q36.3qter), del(9)(p21.3pter), dup(10)(p13pter), del(10)(q26.13q26.3), dup(17) (q12qter), and copy neutral LOH(20)(p11.23p11.21). The recurrent tumor had additional alterations, including del(3)(p21.31q13.31), del(18)(q21.2qter), and a homozygous del(9)(p21.3)(CDKN2A locus) and the sarcoma component had, in addition, del(4)(p14pter), del(6)(q12qter), del(11)(q24.3qter), and del(16)(p11.2pter). In conclusion, unique copy number alterations were identified during tumor progression from a low-grade glioma to gliosarcoma. A subset of alterations developed specifically in the sarcomatous component.

Keywords

Gliosarcoma IDH1 SNP array Secondary glioblastoma Brain 

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Copyright information

© The Japan Society of Brain Tumor Pathology 2013

Authors and Affiliations

  • Kari-Elise T. Codispoti
    • 1
    • 3
  • Stacy Mosier
    • 1
  • Robert Ramsey
    • 2
  • Ming-Tseh Lin
    • 1
  • Fausto J. Rodriguez
    • 1
    • 4
  1. 1.Department of PathologyJohns Hopkins UniversityBaltimoreUSA
  2. 2.Department of PathologyBanner Good Samaritan Medical CenterPhoenixUSA
  3. 3.Children’s National Medical CenterWashington, DCUSA
  4. 4.Division of NeuropathologyJohns Hopkins HospitalBaltimoreUSA

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