Dutta Gautam, Gupta Robin, Garg Manish, Singh Daljit, Singh Hukum, Srivastava Arvind K, Jagetia Anita
Department of Neuro-Surgery, Govind Ballav Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
Surg Neurol Int. 2018 May 29;9:111. doi: 10.4103/sni.sni_31_18. eCollection 2018.
Gliosarcoma is a rare high-grade malignant tumor and a variant of glioblastoma characterized by biphasic glial and mesenchymal components. Gliosarcomas occur most commonly in the fifth or sixth decade of life and have a temporal lobe predilection. Occurrence in the pediatric population is extremely rare.
Here, we report the case of an 8-year-old child with histologically confirmed gliosarcoma at the parieto-occipital lobe. Only a subtotal resection of the tumor mass could be performed in view of massive bleeding from the tumor bed; and despite postoperative chemotherapy and radiotherapy, the tumor recurred in a short span of time. A repeat surgery was done but the patient could not survive.
To our knowledge, this case constitutes the second youngest case reported in the literature with the lesion in the parieto-occipital region and the third youngest in all pediatric cases of gliosarcoma. This case demonstrates that possibility of gliosarcoma should always be kept in mind in children presenting with features of intracranial high-grade glial tumor. This case also suggests that significant residual after surgery is one variable that may affect the prognosis despite radiotherapy and/or chemotherapy.
胶质肉瘤是一种罕见的高级别恶性肿瘤,是胶质母细胞瘤的一种变体,其特征为具有双相性的胶质和间充质成分。胶质肉瘤最常发生于生命的第五或第六个十年,且倾向于发生在颞叶。在儿童人群中发生极为罕见。
在此,我们报告一例8岁儿童,其顶枕叶经组织学确诊为胶质肉瘤。鉴于肿瘤床大量出血,仅对肿瘤肿块进行了次全切除;尽管术后进行了化疗和放疗,但肿瘤在短时间内复发。进行了再次手术,但患者未能存活。
据我们所知,该病例是文献报道中第二例发病年龄最小且病变位于顶枕区的病例,也是所有儿童胶质肉瘤病例中第三例发病年龄最小的病例。该病例表明,对于出现颅内高级别胶质瘤特征的儿童,应始终考虑到胶质肉瘤的可能性。该病例还提示,尽管进行了放疗和/或化疗,但手术后的大量残留是可能影响预后的一个因素。