A case of an anaplastic ependymoma with gliosarcomatous components

Brain Tumor Pathol. 2009;26(1):11-7. doi: 10.1007/s10014-008-0240-x. Epub 2009 Apr 30.

Abstract

A 29-year-old woman presented with a severe headache. Computed tomography revealed a large cystic lesion with a mural nodule-like mass homogeneously enhanced with contrast medium in the right cerebellum. The tumor was removed, and pathological studies revealed a cerebellar astrocytoma corresponding to World Health Organization grade II. When she was 35 years old, or 6 years after the surgery, magnetic resonance imaging revealed a recurrence of the tumor in the right cerebellum, and subtotal removal of the recurrent tumor was performed. Pathological studies revealed a mixed glioblastoma multiforme and anaplastic ependymoma. Chemotherapy (Paraplatin and VePeside-S) and focal radiation therapy at 60 Gy were administered following surgery. Thereafter, at 39 years of age, or 4 years after radiation therapy, magnetic resonance imaging again revealed a recurrence of the tumor, which was heterogeneously enhanced with gadoliniumdiethylenetriamine pentaacetic acid in the right cerebellum. Subtotal removal of the tumor was performed; pathological studies revealed an anaplastic ependymoma with sarcomatous components. Immunohistochemical findings showed some parts of the sarcomatous components to stain positively for glial fibrillary acidic protein and, as a result, these sarcomatous components were diagnosed to be gliosarcoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Astrocytoma / pathology
  • Astrocytoma / surgery
  • Cerebellar Neoplasms / pathology*
  • Cerebellar Neoplasms / surgery
  • Ependymoma / pathology*
  • Ependymoma / surgery
  • Female
  • Glial Fibrillary Acidic Protein / metabolism
  • Gliosarcoma / pathology*
  • Gliosarcoma / surgery
  • Headache / etiology
  • Humans
  • Immunohistochemistry
  • Magnetic Resonance Imaging
  • Neoplasm Recurrence, Local
  • Paraffin Embedding
  • Tomography, X-Ray Computed

Substances

  • Glial Fibrillary Acidic Protein