Histologically repeatedly confirmed gliosarcoma with long survival: Reviewof the literature and report of a case

Objective and Importance. A rare case of gliosarcoma in a 61-year-old woman is presented with a stable situation over 22 years with an excellent quali ty of life. Clinical Presentation. The patient was initially symptomatic and was operat ed on in 1975 for a deep-seated left parietal gliosarcoma. During the follo wing 20 years, she was clinically asymptomatic until she complained of incr easing headache in 1995. Neuroradiological imaging showed a sharply demarca ted lesion on MRI at the former operative site, which was operated on again . Four months later, the residual tumour did grow again. Intervention. As radiation therapy could not stop tumour progression and th e neurological status worsened, the patient was operated on again for a mas sive tumour mass in the left parieto-occipital region, filling out nearly a ll of the previous resection cavity. Despite radio-immunotherapy, the patie nt finally died 22 years after the first discovery of the tumour. Conclusion. The present case shows that, in rare instances, gliosarcomas ma y show prolonged survival, although the underlying pathogenetic mechanisms for this clinical behaviour are not understood.