Gliosarcoma

Gliosarcomas are rare, highly malignant (WHO grade IV) primary intra-axial neoplasms with both glial and mesenchymal elements. They are often considered a histological variant of glioblastoma (GBM) sharing a similar malignant course, prognosis and epidemiological pattern.

Peak presentation is around the 6th decade. There may be a slight male predilection.

The tumour is very similar to a GBM but with an added sarcomatous component (the tumour comprises of both glial and mesenchymal elements). Most lesions are primary but secondary tumours can occur in patients with previously resected GBM or cranial irradiation.

Can be very similar to GBM. There may be slight predilection towards the temporal lobes 1. They are usually broad based peripherally located lesions with possible direct dural invasion or only reactive dural thickening (dural tail3-7.

CT

Gliosarcomas may be seen on CT as a sharply defined (often due to sarcomatous component 5), round or lobulated, hyperdense solid mass. It can have relatively homogeneous contrast enhancement and peritumoral oedema.

MRI

Reported signal characteristics include:

  • T1: heterogeneous and hypointense mass
  • T2:  heterogeneous signal due hemorrhagic and necrotic components
  • T1C+ (Gd): thick irregular and rim-like or ring enhancement 8
Angiography

On angiography, mixed dural and pial vascular supply may be present 3. Early cortical venous drainage, irregular tumour vessels, and a prominent vascular stain with well-defined tumour margins may also be seen.

As with glioblastoma this tumour carries a very poor prognosis. Extracranial metastases can occur in up to 30% of cases.

General imaging differential considerations include:


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Article Information

rID: 9412
Section: Pathology
Synonyms or Alternate Spellings:
  • Gliosarcoma (GSM)
  • Gliosarcomas

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