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Academia Mexicana de Neurología, A.C.

2018, Number 5

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Rev Mex Neuroci 2018; 19 (5)

Gliosarcoma, a variant of the primary Glioblastoma IDH-Wildtype: series of three cases and literature review

Espinosa-Mora JA, Moreira-Ponce LE, Murillo-Ponce CA, Alvear-Quito NM, Cardona-Mejía CE, Ayala-Arcipreste A, Valenzuela-Torres PY, Cuesta-Mejías T, Ramírez-Aguilar R, Mendizábal-Guerra R

Language: Spanish
References: 17
Page: 47-53
PDF size: 444.81 Kb.


ABSTRACT

Introduction: Gliosarcoma is an uncommon primary central nervous system lesion; considered as WHO Grade IV, within the new classification of 2016 is a variant of Glioblastoma (GBM) described as IDH-wildtype, is characterized by a biphasic pattern; with a glial and a mesenchymal component. Clinical similarities to GBM have led many authors to conclude that they are clinically indistinguishable; however, there are a number of important and distinct features of Gliosarcoma that suggest that it is a separate entity. The most striking features to differentiate them include location, differential imaging aspect and gross appearance, but the definitive diagnosis is by histopathological study and confirmed with molecular tests. Case 1: 51-yearold female with a 2-month history of holocranial headache, increased with valsalva maneuvers, improvement with NSAIDs, phosphenes, nausea and postprandial vomiting. Neurological examination: papilloedema, right homonymous hemianopsia, left hemiparesis and hyperreflexia, left Babinsky. Case 2: 40-year-old female, with frontal, evening headache, emotional lability, dysphasia, nausea, vomiting and decreased vision. Neurological examination: motor dysphasia, papillodema, decreased vision, right hemiparesis, apathy, alteration in planning. Case 3: Male, 58-year-old, with a 5-week history of progressive headache, frontal, decreased symmetrical pelvic limb strength. Neurological examination: decreased visión bilateral, left hemiparesis, hypereflexia and left Babinsky. The three patients underwent craniotomy and total resection of the lesion, where a solid lesion of “smoothed” consistency with perilesional gliosi, the histopathological study reports gliosarcoma in all. Conclusions: We present this series of cases with diagnosis of gliosarcoma, which due to the infrequent frequency, we review the literature and present them.


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