Langlois Anne-Marie, Alarfaj Abdullah K, Sagga Aziz, Findlay J Max, Das Sumit
Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada.
Division of Neurosurgery, University of Alberta, Walter Mackenzie Health Sciences Center, Edmonton, Alberta, Canada.
Am J Case Rep. 2019 Jun 27;20:914-919. doi: 10.12659/AJCR.916020.
BACKGROUND Gliosarcoma (GS) is a rare variant of glioblastoma (GBM), which is typically seen in patients age 40-60 years and located in the supratentorial region. We present an unusual case of GS in a young patient with an unusual presentation, which eventually led to the finding of this neoplasm. CASE REPORT Our patient was a 38-year-old woman originally from the Philippines who was transferred to our institution with an isolated left foot drop that developed over the course of several months. Subsequent neuroimaging revealed an extensive mixed cystic and solid mass in the posterior mesial right frontal lobe. Subtotal surgical resection revealed a multi-lobed tumor with a malignant glioma-like surface component overlying a smooth, well-encapsulated, avascular, sarcoma-like component. Neuropathologic examination of the resected tumor revealed a biphasic histologic pattern of predominantly sarcomatous components with fewer adjacent-area glial components. Post-operatively, the patient was left with a mild worsening of left leg segmental strength. She was referred to our neurooncologist colleagues for adjuvant treatment options. CONCLUSIONS Our case is unique in that it represents a rare neoplasm in a patient whose demographics are atypical for this type of tumor, as well as the unusual presentation of isolated foot drop.
胶质肉瘤(GS)是胶质母细胞瘤(GBM)的一种罕见变体,通常见于40至60岁的患者,位于幕上区域。我们报告一例年轻患者的罕见GS病例,其表现不寻常,最终导致了该肿瘤的发现。病例报告:我们的患者是一名38岁的女性,原籍菲律宾,因数月来逐渐出现的单纯左脚下垂被转诊至我院。随后的神经影像学检查显示右额叶内侧后部有一个广泛的混合囊性和实性肿块。次全手术切除显示一个多叶肿瘤,其恶性胶质瘤样表面成分覆盖在一个光滑、包膜良好、无血管的肉瘤样成分之上。对切除肿瘤的神经病理学检查显示出一种双相组织学模式,主要为肉瘤成分,相邻区域的胶质成分较少。术后,患者左腿节段性肌力略有恶化。她被转介给我们的神经肿瘤学同事以寻求辅助治疗方案。结论:我们的病例独特之处在于,它代表了一种在人口统计学特征上不符合此类肿瘤典型情况的患者中的罕见肿瘤,以及单纯足下垂这种不寻常的表现。