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Journal of Neuro-Oncology

, Volume 83, Issue 1, pp 39–46 | Cite as

Gliosarcoma with multiple extracranial metastases: case report and review of the literature

  • Thomas L. Beaumont
  • William J. Kupsky
  • Geoffrey R. Barger
  • Andrew E. Sloan
Clinical–Patient Studies

Abstract

Gliosarcoma is a rare malignant neoplasm of the central nervous system with a propensity for metastasis. There are fewer than 20 reported cases of extracranial metastases of gliosarcoma with the majority of cases reflecting a tendency for hematogenous dissemination. Here we describe the case of a 47-year-old man who developed pervasive extracranial metastases from a temporal gliosarcoma following radio- and chemotherapy for a primary glioblastoma. The patient initially presented with progressively worsening headaches, left-sided weakness and numbness associated with right temporo-parietal mass for which he underwent craniotomy with stereotactic gross-total excision. Two months postoperatively, interstitial brachytherapy and external beam radiotherapy were initiated. The patient initially declined chemotherapy. The tumor recurred twice and the patient underwent re-operation and multiple courses of chemotherapy; histopathological diagnosis remained glioblastoma multiforme. Nineteen months following initial resection the patient’s clinical status deteriorated and CT scan demonstrated multiple intrathoracic, hepatic and splenic lesions. Postmortem examination revealed widespread, infiltrating gliosarcoma with intravascular gliomatosis and extensive visceral metastases. This is the first report of pervasive extracranial metastases to numersous sites, several of which have not been previously reported. The histogenesis and the potential role of therapeutic irradiation in the development of gliosarcoma are briefly reviewed.

Keywords

Extracranial Glioma Gliosarcoma Metastasis Sarcoma 

Notes

Acknowledgements

We thank Dr. Bradley McCollum for his assistance with the imaging of the pathological specimens and Drs. Marc Chamberlain and Richard Rhiew for their helpful discussions and critical review of the manuscript. We also thank Dr. Otto Muzik for compiling the PET data. AES was supported in part by a grant from the NCI (CA101954).

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Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Thomas L. Beaumont
    • 1
  • William J. Kupsky
    • 2
    • 3
  • Geoffrey R. Barger
    • 2
  • Andrew E. Sloan
    • 1
    • 4
  1. 1.Department of Neurosurgery, Karmanos Cancer InstituteWayne State University School of MedicineDetroitUSA
  2. 2.Department of Neurology, Karmanos Cancer InstituteWayne State University School of MedicineDetroitUSA
  3. 3.Department of Pathology, Karmanos Cancer InstituteWayne State University School of MedicineDetroitUSA
  4. 4.Department of Neurosurgery CaseWestern University School of medicineClevelandUSA

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