A Nonradiated Grade II Glioma That Underwent Delayed Malignant Transformation to a Gliosarcoma with Meningeal Growth and Dissemination - Université de Lorraine Access content directly
Journal Articles Journal of Neurological Surgery Part A: Central European Neurosurgery Year : 2014

A Nonradiated Grade II Glioma That Underwent Delayed Malignant Transformation to a Gliosarcoma with Meningeal Growth and Dissemination

Abstract

Background: Secondary gliosarcomas are rare tumors, especially those arising from a World Health Organization (WHO) grade II glioma not irradiated. We report a case with subtotal resection for a WHO grade II oligoastrocytoma, without adjuvant treatment, whose metaplastic transformation into gliosarcoma suddenly occurred 4 years later with meningeal dissemination. We show a favorable outcome after therapeutic management of this rare entity.Patient: A 46 year-old woman underwent surgery for a right premotor WHO grade II oligoastrocytoma discovered incidentally. Because of a subtotal resection with only 1 cc of residue, no complementary therapy was given, and the patient enjoyed a normal life for 4 years. In the meantime, the magnetic resonance images performed every 6 months showed a very low growth rate. Suddenly, the tumor switched toward a gliosarcoma profile with meningeal dissemination.Results: Reoperation, radiotherapy, and chemotherapy were performed, enabling a control of the disease with 15 months of follow-up (i.e., with radiologic shrinkage of the multiple lesions and preservation of quality of life).Conclusion: A delayed sarcomatous transformation can acutely occur with a low proliferation index in a nonirradiated WHO grade II oligoastrocytoma. Furthermore, an aggressive therapeutic strategy can allow control of secondary gliosarcomas, even in cases of leptomeningeal spreading.
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hal-01687103 , version 1 (18-01-2018)

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Fabien Rech, Valérie Rigau, Michel Fabbro, Christine Kerr, Guillaume Gauchotte, et al.. A Nonradiated Grade II Glioma That Underwent Delayed Malignant Transformation to a Gliosarcoma with Meningeal Growth and Dissemination. Journal of Neurological Surgery Part A: Central European Neurosurgery, 2014, 75 (06), pp.485-490. ⟨10.1055/s-0034-1372437⟩. ⟨hal-01687103⟩
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