Gliosarcoma: a case with unusual epithelial feature

Abstract

Astrocytic tumors, particularly gliosarcoma, may contain epithelial features in the form of trabecular, adenoid, papillary arrangement, and squamous metaplasia. A case of gliosarcoma with unusual epithelial feature is described. The patient was a 60-year-old male with frequent seizures. The mass was 4 cm and in the left frontal lobe. Trabecular or rarely adenoid arrangement of neoplastic astrocytes was present in the mucinous stroma, and there was a distinctive transition between the trabecular area and typical anaplastic astrocytoma. The tumor cells in the trabecular area showed positive immunostain for glial fibrillary acidic protein, but did not react with various kinds of cytokeratin. The sarcomatous area was undifferentiated and was not labeled by factor-VIII, desmin, and anti-smooth muscle actin. Occurrence and histogenesis of epithelial features in gliosarcoma are reviewed. The importance to recognize the existence of epithelial feature in malignant astrocytic tumor is emphasized.

Gliosarcoma: A rare primary CNS tumor. Presentation of two cases

“…GS has been described to show mesenchymal differentiation other than fibrosarcoma, as occurs in epilethial differentiation, myofibroblasts, cartilage, bone, angiosarcoma, smooth muscle and striated muscle. [13][14][15][16][17][18][19] The glial component is astrocytic and mimics glioblastoma.…”

Gliosarcoma with epithelial differentiation: immunohistochemical and molecular characterization. A case report and review of the literature

“…2,22 Rarely, gliosarcomas with focal epithelial features have been described. [6][7][8] The interpretation of these lesions as variants of glioblastoma have been based on partial expression of GFAP in the epithelial areas as well as no evidence of another primary tumor. To our knowledge, only the study of Mueller et al 19 investigated clonality in these tumors by studying the patterns of TP53 mutation in different areas of the tumor.…”

“…4,5 Rare reports have noted distinctive epithelial histology within glioblastoma or gliosarcomas displaying squamoid or glandular appearances with negative immunohistochemical staining for glial fibrillary acidic protein (GFAP) and positivity for cytokeratin expression. [6][7][8][9][10] These unusual cases can pose not only diagnostic dilemmas, but clinical management issues as to whether these distinctive areas represent metastasis from an extracranial tumor, as has been described, 11 or a primary manifestation of the high-grade astrocytic neoplasm. Oh and Prayson 12 has suggested the use of GFAP and CAM 5.2 immunostains in order to differentiate metastatic carcinoma from glioblastoma.…”

Malignant Astrocytomas

“…90 III. [94][95][96] Posterior fossa gliosarcomas have also been reported. The glial component usually demonstrates the typical features of GBM.…”