Barut Figen, Kandemir Nilufer Onak, Ozdamar Sukru Oguz, Gul Sanser, Bektas Sibel, Gun Banu Dogan, Bahadir Burak
Zonguldak Karaelmas University Faculty of Medicine, Department of Pathology, Zonguldak, Turkey.
Turk Neurosurg. 2009 Oct;19(4):417-22.
Gliosarcoma is a rare tumor of the central nervous system characterized by a biphasic histological pattern. Our objective is to describe clinical, morphological and immunohistochemical features of two cases of gliosarcoma with chondroblastic osteosarcomatous differentiation and to discuss its pathogenetic mechanisms. CASE 1: A 52- year-old male patient underwent parietal craniotomy due to anaplastic ependymoma. The case had radiotherapy and chemotherapy postoperatively. After the first operation, additional resections were performed for tumor because of recurrences at the fourth, seventh and tenth months. The patient died after the last tumor resection. Histopathologic examination of the postmortem biopsy revealed neoplasm displaying a biphasic morphologic pattern including both gliomatous and sarcomatous components. CASE 2: The case was a 69-year-old male patient with a right frontal lobe mass histologically diagnosed as gliosarcoma displaying sarcomatous and glial components. Immunohistochemical features were similar to those of the first case in general, but diffuse nuclear reaction with p53 protein was detected in both components. We report two cases with an extremely rare histopathological diagnosis of "gliosarcoma with features of chondroblastic osteosarcoma".
胶质肉瘤是一种罕见的中枢神经系统肿瘤,具有双相组织学模式。我们的目的是描述两例具有软骨母细胞性骨肉瘤分化的胶质肉瘤的临床、形态学和免疫组化特征,并探讨其发病机制。病例1:一名52岁男性患者因间变性室管膜瘤接受了顶叶开颅手术。该病例术后接受了放疗和化疗。首次手术后,由于在第4、7和10个月复发,对肿瘤进行了额外切除。患者在最后一次肿瘤切除后死亡。尸检活检的组织病理学检查显示肿瘤呈现双相形态模式,包括胶质瘤和肉瘤成分。病例2:该病例为一名69岁男性患者,右侧额叶肿块经组织学诊断为胶质肉瘤,显示肉瘤和神经胶质成分。免疫组化特征总体上与第一例相似,但在两个成分中均检测到p53蛋白的弥漫性核反应。我们报告了两例组织病理学诊断极为罕见的“具有软骨母细胞性骨肉瘤特征的胶质肉瘤”病例。