Gliosarcoma in the Cerebellopontine Angle with Rapid Tumor Growth and Intratumoral Hemorrhage

Duan, Hongzhou; Kitazawa, Kazuo; Yako, Takehiro; Ichinose, Shunsuke; Kobayashi, Shigeaki; Sudo, Motohiro

doi:10.1016/j.wneu.2016.06.053

Cited by 9 publications

(25 citation statements)

References 11 publications

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“…14,21 Multiple rare primary locations for these lesions have been described, including the cerebellum, pineal region, cerebellopontine angle, intraventricular, and within the spinal cord. 11,[22][23][24][25][26] While distant metastases were not reported in this group of patients, extracranial local extension was seen in three cases, with one involving the masticator space. The more commonly seen finding of temporal lobe involvement was noted in the majority of our studies, concordant with a study of 353 GSC through the Surveillance, Epidemiology, and End Results (SEER) database which demonstrated that GSC had a higher propensity for temporal lobe involvement than GBM.…”

Section: Discussionmentioning

confidence: 59%

“…Another unique feature of GSC is its ability to metastasize to multiple sites outside of the CNS . Multiple rare primary locations for these lesions have been described, including the cerebellum, pineal region, cerebellopontine angle, intraventricular, and within the spinal cord . While distant metastases were not reported in this group of patients, extracranial local extension was seen in three cases, with one involving the masticator space.…”

Section: Discussionmentioning

confidence: 68%

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Gliosarcoma: Neuroimaging and Immunohistochemical Findings

Peckham

Osborn

Palmer

et al. 2018

Journal of Neuroimaging

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BACKGROUND AND PURPOSE Gliosarcoma (GSC) is an intra‐axial lesion which often abuts a dural margin and is composed of glial and mesenchymal elements. This lesion is considered a variant of isocitrate dehydrogenase (IDH)‐wild type glioblastoma (GBM). The purpose of this study is to evaluate the imaging and molecular features of GSC in a large patient cohort. METHODS Pathology‐proved GSC cases were collected from our quaternary care center spanning the last 16 years and IDH status was documented. Older GSC cases without prior immunohistochemical testing underwent tissue block staining to obtain IDH status. When available, p53, phosphate and tensin (PTEN), MIB‐1, EGFR amplification, and MGMT methylation were recorded and imaging findings tabulated. Logistic regression analyses were performed to determine correlation of molecular markers and imaging characteristics. RESULTS A total of 25 cases were identified (21 de novo, 4 post‐treatment). All lesions contacted a dural, pial, or ependymal surface and were negative for an IDH R132H mutation, including postradiation GSC. In total, 16 of 16 cases showed nonamplification of EGFR/CEP7, 2 of 16 demonstrated MGMT methylation, and multiple lesions demonstrated p53 and PTEN mutations. Imaging features included areas of nodular thickening in necrotic lesions which appeared to abut the site of dural contact. There was no significant correlation of molecular markers with imaging characteristics. CONCLUSION GSC was IDH(–) in all cases, supporting the current understanding of this lesion being a wild‐type GBM variant. Additional molecular markers demonstrated no significant correlation with imaging findings in this cohort.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 68%

Gliosarcoma: Neuroimaging and Immunohistochemical Findings

Peckham

Osborn

Palmer

et al. 2018

Journal of Neuroimaging

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“…Vestibular symptoms as dizziness, hearing loss and tinnitus and, in some case facial palsy, reveals the nerve involving and damage. [25][26][27][28][29][30][31][32][33][34] Table 1 summarizes cancer and/or mass (common and rare) that can arise in the IAC.…”

Section: Discussionmentioning

confidence: 99%

“…Gliosarcoma, hemangiopericitoma and metastasis in the IAC are treated with surgical approach associated to radio/chemotherapy. 25,26 The conservative approach using gamma knife therapy can be useful if Schwannoma has a small volume. 35 The posterior fossa approach is the best option to treat meningioma.…”

Section: Discussionmentioning

confidence: 99%

Arachnoid Cyst of Internal Auditory Canal How the Temporal Bone Findings Explain Ear Symptoms and Suggest the Best Treatment To Do

Stadio¹

2016

Otolaryngol Open J

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PubMed and Google Scholar searches using the following keywords: arachnoid cyst, internal auditory canal, temporal bones study, schwannoma of internal auditory canal, cystic schwannoma, MRI findings, surgery of internal auditory canal. Only the article where three keywords, included always arachnoid cyst, were considered. The study analyzed the etiopathogenesis of arachnoid cyst, hearing and vestibular symptoms and temporal bone findings. Review and conclusion: The author identified and reviewed a total of 46 articles. The results showed high incidence of hearing loss that was the more common symptom than vestibular one. Arachnoid cyst carried out more compression on the vestibular nerves than on the cochlear one. The review allowed us to identify which mechanism of damage arachnoid cyst acting on the nerves. It is necessary to consider the arachnoids cyst in differential diagnosis with tumors and pathologies involving the internal auditory canal.

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“…4 Three preceding case reports have described GBM or gliosarcoma within the IAC (Table 1). 3,17,18 These authors suggested that tumors arose from the cerebellum, pons, and CN VIII, based on their intraoperative and imaging findings. However, review of the published radiographic images demonstrates that, in each case, the tumors had wide attachment to the petrous bone, as well as clear cerebellar components, as opposed to the discrete nature of the initial lesion we identified with no discernable intraaxial attachment.…”

Section: Discussionmentioning

confidence: 99%

Glioblastoma of the cerebellopontine angle and internal auditory canal mimicking a peripheral nerve sheath tumor: case report

Takami¹,

Prummer

Graffeo³

et al. 2019

Journal of Neurosurgery

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Glioblastoma (GBM) of the internal auditory canal (IAC) is exceedingly rare, with only 3 prior cases reported in the literature. The authors present the fourth case of cerebellopontine angle (CPA) and IAC GBM, and the first in which the lesion mimicked a vestibular schwannoma (VS) early in its natural history. A 55-year-old man presented with tinnitus, hearing loss, and imbalance. MRI identified a left IAC/CPA lesion measuring 8 mm, most consistent with a benign VS. Over the subsequent 4 months he developed facial weakness. The tumor grew remarkably to 24 mm and surgery was recommended; the main preoperative diagnosis was malignant peripheral nerve sheath tumor (MPNST). Resection proceeded via a translabyrinthine approach with resection of cranial nerves VII and VIII, followed by facial-hypoglossal nerve anastomosis. Intraoperative frozen section suggested malignant spindle cell neoplasm, but final histopathological and molecular testing confirmed the lesion to be a GBM. The authors report the first case in which absence of any brainstem interface effectively excluded a primary parenchymal tumor, in particular GBM, from the differential diagnosis. Given the dramatic differences in treatment and prognoses between malignant glioma and MPNST, this case emphasizes the importance of surgical intervention on an aggressively growing lesion, which provides both the best probability of local control and the critical tissue diagnosis.

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Gliosarcoma in the Cerebellopontine Angle with Rapid Tumor Growth and Intratumoral Hemorrhage

Cited by 9 publications

References 11 publications

Gliosarcoma: Neuroimaging and Immunohistochemical Findings

Gliosarcoma: Neuroimaging and Immunohistochemical Findings

Arachnoid Cyst of Internal Auditory Canal How the Temporal Bone Findings Explain Ear Symptoms and Suggest the Best Treatment To Do

Glioblastoma of the cerebellopontine angle and internal auditory canal mimicking a peripheral nerve sheath tumor: case report

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