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Li A, Hancock JC, Quezado M, Ahn S, Briceno N, Celiku O, Ranjan S, Aboud O, Colwell N, Kim SA, Nduom E, Kuhn S, Park DM, Vera E, Aldape K, Armstrong TS, Gilbert MR. TGF-β and BMP signaling are associated with the transformation of glioblastoma to gliosarcoma and then osteosarcoma. Neurooncol Adv 2024; 6:vdad164. [PMID: 38292240 PMCID: PMC10825841 DOI: 10.1093/noajnl/vdad164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Background Gliosarcoma, an isocitrate dehydrogenase wildtype (IDH-WT) variant of glioblastoma, is defined by clonal biphasic differentiation into gliomatous and sarcomatous components. While the transformation from a glioblastoma to gliosarcoma is uncommon, the subsequent transformation to osteosarcoma is rare but may provide additional insights into the biology of these typically distinct cancers. We observed a patient initially diagnosed with glioblastoma, that differentiated into gliosarcoma at recurrence, and further evolved to osteosarcoma at the second relapse. Our objective was to characterize the molecular mechanisms of tumor progression associated with this phenotypic transformation. Methods Tumor samples were collected at all 3 stages of disease and RNA sequencing was performed to capture their transcriptomic profiles. Sequential clonal evolution was confirmed by the maintenance of an identical PTEN mutation throughout the tumor differentiation using the TSO500 gene panel. Publicly available datasets and the Nanostring nCounter technology were used to validate the results. Results The glioblastoma tumor from this patient possessed mixed features of all 3 TCGA-defined transcriptomic subtypes of an IDH-WT glioblastoma and a proportion of osteosarcoma signatures were upregulated in the original tumor. Analysis showed that enhanced transforming growth factor-β (TGF-β) and bone morphogenic protein signaling was associated with tumor transformation. Regulatory network analysis revealed that TGF-β family signaling committed the lineage tumor to osteogenesis by stimulating the expression of runt-related transcription factor 2 (RUNX2), a master regulator of bone formation. Conclusions This unusual clinical case provided an opportunity to explore the modulators of longitudinal sarcomatous transformation, potentially uncovering markers indicating predisposition to this change and identification of novel therapeutic targets.
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Affiliation(s)
- Aiguo Li
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - John C Hancock
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Martha Quezado
- Laboratory of Pathology, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Susie Ahn
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Nicole Briceno
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Orieta Celiku
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Surabhi Ranjan
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Orwa Aboud
- Department of Neurology and Neurological Surgery, University of California, Davis, Sacramento, California, USA
| | - Nicole Colwell
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Sun A Kim
- Laboratory of Pathology, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Edjah Nduom
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Skyler Kuhn
- Research Technology Branch, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland, USA
| | - Deric M Park
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Elizabeth Vera
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Ken Aldape
- Laboratory of Pathology, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland, USA
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Chen Y, Zhou S, Zhou X, Dai X, Wang L, Chen P, Zhao S, Shi C, Xiao S, Dong J. Gliosarcoma with osteosarcomatous component: A case report and short review illustration. Pathol Res Pract 2022; 232:153837. [DOI: 10.1016/j.prp.2022.153837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/27/2022] [Accepted: 03/05/2022] [Indexed: 11/29/2022]
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3
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Tu JH, Piao YS, Lu DH, Wang LM, Liu L, Bai DY, Han HW, Lin YK, Zhong S. An adult case of diffuse midline glioma with H3 K27M mutation. Neuropathology 2020; 40:627-631. [PMID: 32954563 DOI: 10.1111/neup.12689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/15/2020] [Accepted: 05/14/2020] [Indexed: 11/30/2022]
Abstract
Cartilaginous metaplasia is rare in primary central nervous system (CNS) neoplasms and has not been described in the histone 3 (H3) gene (H3) with a substitution of lysine to methionine (H3 K27M mutant) diffuse midline glioma before. Here, we report a case of H3 K27M mutant diffuse midline glioma with cartilaginous metaplasia in a 56-year-old woman. Magnetic resonance imaging (MRI) revealed a ring-enhanced lesion located in the medulla oblongata and extended superiorly into the fourth ventricle. The tumor was macroscopically completely resected. Histologically, the tumor was composed of a gliomatous component and a well-differentiated cartilaginous component. Microvascular proliferation and necrosis were noted. According to immunohistochemical staining, glial cells were diffusely and strongly positive for glial fibrillary acidic protein (GFAP), oligodendrocyte lineage transcription factor 2 (Olig2), H3 K27M, and S-100 protein but negative for H3K27me3. The chondrocytes also were positive for GFAP and S-100 protein. The H3 K27M mutation was confirmed by sequencing in both the gliomatous and cartilaginous components, suggesting a common origin from the same progenitor cells. Based on these findings, the tumor was diagnosed as a diffuse midline glioma with H3 K27M mutation with widespread cartilaginous metaplasia, corresponding to WHO grade IV. This is an extremely rare H3 K27M mutant diffuse midline glioma with cartilaginous metaplasia, and reporting this unusual case adds to the understanding of this tumor type.
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Affiliation(s)
- Jin-Hua Tu
- Department of Pathology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Yue-Shan Piao
- Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - De-Hong Lu
- Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lei-Ming Wang
- Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li Liu
- Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Dong-Yu Bai
- Department of Pathology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Hai-Wei Han
- Department of Radiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Yi-Kai Lin
- Department of Radiology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Shan Zhong
- Department of Pathology, The First Affiliated Hospital of Xiamen University, Xiamen, China
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Langlois AM, Alarfaj AK, Sagga A, Findlay JM, Das S. Gliosarcoma in a Young Filipino Woman: A Case Report and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:914-919. [PMID: 31243260 PMCID: PMC6613492 DOI: 10.12659/ajcr.916020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Patient: Female, 28 Final Diagnosis: Gliosarcoma Symptoms: Foot drop Medication: — Clinical Procedure: — Specialty: Neurosurgery
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Affiliation(s)
- Anne-Marie Langlois
- Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Abdullah K Alarfaj
- Division of Neurosurgery, University of Alberta, Walter Mackenzie Health Sciences Center, Edmonton, Alberta, Canada
| | - Aziz Sagga
- Division of Neurosurgery, University of Alberta, Walter Mackenzie Health Sciences Center, Edmonton, Alberta, Canada
| | - J Max Findlay
- Division of Neurosurgery, University of Alberta, Walter Mackenzie Health Sciences Center, Edmonton, Alberta, Canada
| | - Sumit Das
- Division of Neuropathology, University of Alberta, Walter Mackenzie Health Sciences Center, Edmonton, Alberta, Canada.,Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
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Yoshida Y, Ide M, Fujimaki H, Matsumura N, Nobusawa S, Ikota H, Yokoo H. Gliosarcoma with primitive neuronal, chondroid, osteoid and ependymal elements. Neuropathology 2018; 38:392-399. [PMID: 29504169 DOI: 10.1111/neup.12461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/29/2018] [Accepted: 02/02/2018] [Indexed: 12/30/2022]
Abstract
A 51-year-old man presented with a 2-week history of malaise. MRI revealed a large solid and cystic lesion with ring enhancement measuring 6.5 cm in diameter in the right frontal lobe. Histologically, the tumor consisted of various components: diffuse growth of atypical astrocytic cells consistent with glioblastoma, fascicular proliferation of atypical spindle cells such as fibrosarcoma, clusters of primitive neuronal cells, and foci of ependymal cells. The sarcomatous component also focally exhibited chondroid and osteoid differentiation. Immunohistochemically, tumor cells in the primitive neuronal component were immunoreactive for synaptophysin and CD56. The spindle cells were immunopositive for Slug and Twist, regulators of epithelial-mesenchymal transition. Direct DNA sequencing demonstrated C228T mutation in the TERT promoter in astrocytic, sarcomatous and primitive neuronal components, suggesting their identical origin. Although a few cases of gliosarcoma with primitive neuronal differentiation have previously been described, the finding that neuronal, glial and sarcomatous components share an identical mutation of the TERT promoter has not been reported. The tumor recurred at the original site 11 months after the first surgery. Interestingly, the recurrent tumor was composed exclusively of a glioblastomatous component, unlike past cases of recurrent gliosarcoma.
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Affiliation(s)
- Yuka Yoshida
- Department of Human Pathology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Munenori Ide
- Department of Pathology, Maebashi Red Cross Hospital, Maebashi, Japan
| | - Hiroya Fujimaki
- Department of Neurosurgery, Maebashi Red Cross Hospital, Maebashi, Japan
| | - Nozomi Matsumura
- Department of Human Pathology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Sumihito Nobusawa
- Department of Human Pathology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hayato Ikota
- Department of Human Pathology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hideaki Yokoo
- Department of Human Pathology, Gunma University Graduate School of Medicine, Gunma, Japan
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Poyuran R, Bn N, Reddy YVK, Savardekar AR. Intraventricular gliosarcoma with dual sarcomatous differentiation: A unique case. Neuropathology 2017; 37:346-350. [PMID: 28261869 DOI: 10.1111/neup.12369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 10/20/2022]
Abstract
Gliosarcoma, a variant of isocitrate dehydrogenase-wildtype glioblastoma, is largely a lobar surfacing neoplasm often with dural attachment. In this biphasic neoplasm, the sarcomatous component usually takes the form of fibrosarcoma or malignant fibrous histiocytoma. Heterologous sarcomatous differentiation is a rare phenomenon. Here, we present a case of gliosarcoma with liposarcomatous and myosarcomatous differentiation in a 68-year-old man which was purely intraventricular. This is the first report of such a morphologic pattern in this location. Varied histological components with their immunohistochemical profile are discussed. Of note was the presence of a p53 negative giant cell glioblastoma component, as was the expression in the rest of the tumor.
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Affiliation(s)
| | - Nandeesh Bn
- Department of Neuropathology, NIMHANS, Bangalore, Karnataka, India
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Wang L, Xie Y, Liu Y, Tan J, Chen Z, Xiao Y, Xia Y, Peng Z. Brachium Pontis Gliosarcoma With Well-Differentiated Cartilaginous Tissue: A Case Report. Medicine (Baltimore) 2015; 94:e1735. [PMID: 26496287 PMCID: PMC4620754 DOI: 10.1097/md.0000000000001735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Gliosarcoma (GS) belongs to World Health Organization grade IV neoplasm and displaying glial and mesenchymal differentiation. Only rare cases of GS have been reported in the brachium pontis and 4th ventricle region. Here, we report a rare case of GS located on brachium pontis region and extending into the 4th ventricle with well-differentiated cartilaginous metaplasia. A 28-year-old male patient experienced intermittent headache, vomiting, and gait disorders for 3 months. Magnetic resonance imaging (MRI) showed a heterogeneous ring-enhancement lesion with weak central enhancement in left brachium pontis and 4th ventricle region. Histology revealed the GS was constituted with glial and sarcomatous elements. After immunohistochemical analysis, a diagnosis of GS with cartilaginous differentiation was then made.Symptoms of GS, including headache, aphasia, hemiparesis, cognitive decline, and seizures, mainly determined by the location. The clinical manifestation and radiologic characteristic is not significantly different from that of glioblastoma. The grade of resection is the significant factor related to prognosis of GS, and the clinical effect of adjuvant radiotherapy and chemotherapy need further study. Reporting additional cases would be of great help in better understanding of this location and pathologic type of GS.
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Affiliation(s)
- Lei Wang
- From the Department of Neurosurgery, Xiangya Hospital Central South University, Changsha (LW, YX, JT, ZC, YX, ZP); Department of Neurosurgery, Affiliated Haikou Hospital Xiangya School of Central South University, Haikou (LW, YX); and Department of Neurology, Changsha City Central Hospital, Changsha, China (YL)
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Khan I, Bangash M, Baeesa S, Jamal A, Carracedo A, Alghamdi F, Qashqari H, Abuzenadah A, AlQahtani M, Damanhouri G, Chaudhary A, Hussein D. Epidemiological trends of histopathologically WHO classified CNS tumors in developing countries: systematic review. Asian Pac J Cancer Prev 2015; 16:205-16. [PMID: 25640353 DOI: 10.7314/apjcp.2015.16.1.205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many developing countries are lagging behind in reporting epidemiological data for individual central nervous system (CNS) tumors. This paper aimed to elicit patterns for the epidemiology of individual World Health Organization (WHO) classified CNS tumors in countries registered by WHO as "developing". MATERIALS AND METHODS Cyber search was carried out through 66 cancer networks/registries and 181 PubMed published papers that reported counts of CNS tumors for the period of 2009-2012. The relationship between the natural log of incidence Age Standardized Rate (ASR) reported by Globocan and Latitude/ Longitude was investigated. RESULTS Registries for 21 countries displayed information related to CNS tumors. In contrast tends for classified CNS tumor cases were identified for 38 countries via 181 PubMed publications. Extracted data showed a majority of unclassified reported cases [PubMed (38 countries, 45.7%), registries (21 countries, 96.1%)]. For classified tumors, astrocytic tumors were the most frequently reported type [PubMed (38 countries, 1,245 cases, 15.7%), registries (21 countries, 627 cases, 1.99%]. A significant linear regression relationship emerged between latitudes and reported cases of CNS tumors. CONCLUSIONS Previously unreported trends of frequencies for individually classified CNS tumors were elucidated and a possible link of CNS tumors occurrence with geographical location emerged.
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Affiliation(s)
- Ishaq Khan
- Center of Excellence in Genomic Medicine, King Abdulaziz University, Jeddah, Saudi Arabia E-mail :
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Gliosarcoma with osseous tissue: an occasional metaplastic component. Brain Tumor Pathol 2012; 30:40-4. [DOI: 10.1007/s10014-012-0096-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Accepted: 03/09/2012] [Indexed: 10/28/2022]
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