Gliosarcoma arising from oligodendroglioma (Oligosarcoma): A case report with genetic analyses

Pathol Int. 2018 Oct;68(10):567-573. doi: 10.1111/pin.12723. Epub 2018 Sep 23.

Abstract

Gliosarcomas are a type of bimorphic tumor composed of glial and sarcomatous elements, and are considered to be a variant of glioblastoma, WHO grade IV. To date, only rare cases of gliosarcoma with oligodendroglial components (oligosarcoma) have been reported. We report a case of oligosarcoma consisting of gliosarcoma arising from recurrent oligodendroglioma. A 53-year-old man, who had undergone a gross total resection of oligodendroglioma (WHO grade II) 11 years earlier, presented with a local tumor recurrence. The patient underwent a second gross total resection, whereupon a histopathological examination further revealed residual features of classical oligodendroglioma, and newly-developed sarcomatous characteristics. Both the primary and recurrent tumors showed 1p/19q co-deletion and mutation of the isocitrate dehydrogenase 1 (IDH1) gene, consistent with being oligodendroglial in nature. Loss of heterozygosity (LOH) of chromosome 1p/19q and IDH1 mutation have seldom been analyzed in previous reports of oligosarcomas. We report a rare case study supported by the results of genetic analyses. Our analyses have revealed that the sarcomatous component represents a metaplastic change occurring in the oligodendroglial element.

Keywords: 1p/19q co-deletion; gliosarcoma; oligodendroglioma; oligosarcoma.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / genetics
  • Brain Neoplasms / pathology*
  • Chromosomes, Human, Pair 1 / genetics
  • Chromosomes, Human, Pair 19 / genetics
  • Gene Deletion
  • Gliosarcoma / genetics
  • Gliosarcoma / pathology*
  • Humans
  • Isocitrate Dehydrogenase / genetics
  • Male
  • Middle Aged
  • Mutation
  • Neoplasm Recurrence, Local / genetics
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasms, Multiple Primary / genetics
  • Neoplasms, Multiple Primary / pathology*
  • Oligodendroglioma / genetics
  • Oligodendroglioma / pathology*

Substances

  • Isocitrate Dehydrogenase
  • IDH1 protein, human