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Liu L, Liu Y, Chen J, Jiang T, Liu X, Zhang KN. Methylation class oligosarcoma, IDH-mutant could exhibit astrocytoma-like molecular features. Acta Neuropathol 2024; 147:49. [PMID: 38443510 DOI: 10.1007/s00401-024-02715-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Lingyu Liu
- Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yuqing Liu
- Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Jing Chen
- Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Tao Jiang
- Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Xing Liu
- Department of Neuropathology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| | - Ke-Nan Zhang
- The Preston Robert Tisch Brain Tumor Center at Duke, Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
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La Torre D, Della Torre A, Lo Turco E, Longo P, Pugliese D, Lacroce P, Raudino G, Romano A, Lavano A, Tomasello F. Primary Intracranial Gliosarcoma: Is It Really a Variant of Glioblastoma? An Update of the Clinical, Radiological, and Biomolecular Characteristics. J Clin Med 2023; 13:83. [PMID: 38202090 PMCID: PMC10779593 DOI: 10.3390/jcm13010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Gliosarcomas (GS) are sporadic malignant tumors classified as a Glioblastoma (GBM) variant with IDH-wild type phenotype. It appears as a well-circumscribed lesion with a biphasic, glial, and metaplastic mesenchymal component. The current knowledge about GS comes from the limited literature. Furthermore, recent studies describe peculiar characteristics of GS, such as hypothesizing that it could be a clinical-pathological entity different from GBM. Here, we review radiological, biomolecular, and clinical data to describe the peculiar characteristics of PGS, treatment options, and outcomes in light of the most recent literature. A comprehensive literature review of PubMed and Web of Science databases was conducted for articles written in English focused on gliosarcoma until 2023. We include relevant data from a few case series and only a single meta-analysis. Recent evidence describes peculiar characteristics of PGS, suggesting that it might be a specific clinical-pathological entity different from GBM. This review facilitates our understanding of this rare malignant brain tumor. However, in the future we recommend multi-center studies and large-scale metanalyses to clarify the biomolecular pathways of PGS to develop new specific therapeutic protocols, different from conventional GBM therapy in light of the new therapeutic opportunities.
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Affiliation(s)
- Domenico La Torre
- Department of Medical and Surgery Sciences, School of Medicine, AOU “Renato Dulbecco”, University of Catanzaro, 88100 Catanzaro, Italy; (A.D.T.); (P.L.); (P.L.); (A.L.)
| | - Attilio Della Torre
- Department of Medical and Surgery Sciences, School of Medicine, AOU “Renato Dulbecco”, University of Catanzaro, 88100 Catanzaro, Italy; (A.D.T.); (P.L.); (P.L.); (A.L.)
| | - Erica Lo Turco
- Department of Medical and Surgery Sciences, School of Medicine, AOU “Renato Dulbecco”, University of Catanzaro, 88100 Catanzaro, Italy; (A.D.T.); (P.L.); (P.L.); (A.L.)
| | - Prospero Longo
- Department of Medical and Surgery Sciences, School of Medicine, AOU “Renato Dulbecco”, University of Catanzaro, 88100 Catanzaro, Italy; (A.D.T.); (P.L.); (P.L.); (A.L.)
| | - Dorotea Pugliese
- Humanitas, Istituto Clinico Catanese, 95045 Catania, Italy; (D.P.); (G.R.); (A.R.); (F.T.)
| | - Paola Lacroce
- Department of Medical and Surgery Sciences, School of Medicine, AOU “Renato Dulbecco”, University of Catanzaro, 88100 Catanzaro, Italy; (A.D.T.); (P.L.); (P.L.); (A.L.)
| | - Giuseppe Raudino
- Humanitas, Istituto Clinico Catanese, 95045 Catania, Italy; (D.P.); (G.R.); (A.R.); (F.T.)
| | - Alberto Romano
- Humanitas, Istituto Clinico Catanese, 95045 Catania, Italy; (D.P.); (G.R.); (A.R.); (F.T.)
| | - Angelo Lavano
- Department of Medical and Surgery Sciences, School of Medicine, AOU “Renato Dulbecco”, University of Catanzaro, 88100 Catanzaro, Italy; (A.D.T.); (P.L.); (P.L.); (A.L.)
| | - Francesco Tomasello
- Humanitas, Istituto Clinico Catanese, 95045 Catania, Italy; (D.P.); (G.R.); (A.R.); (F.T.)
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3
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Abstract
Gliosarcoma is a variant of glioblastoma with equally poor prognosis and characterized by mixed glial and mesenchymal pathology. Metastasis is not uncommon but the involvement of the spinal cord is rare, and comprehensive genetic characterization of spinal gliosarcoma is lacking. We describe a patient initially diagnosed with a low-grade brain glioma via biopsy, followed by adjuvant radiation and temozolomide treatment. Nearly 2 years after diagnosis, she developed neurological deficits from an intradural, extramedullary tumor anterior to the spinal cord at T4, which was resected and diagnosed as gliosarcoma. Whole-exome sequencing (WES) of this tumor revealed a hypermutated phenotype, characterized by somatic mutations in key DNA mismatch repair (MMR) pathway genes, an abundance of C>T transitions within the identified somatic single nucleotide variations, and microsatellite stability, together consistent with temozolomide-mediated hypermutagenesis. This is the first report of a hypermutator phenotype in gliosarcoma, which may represent a novel genomic mechanism of progression from lower grade glioma.
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Anderson KJ, Tan AC, Parkinson J, Back M, Kastelan M, Newey A, Brewer J, Wheeler H, Hudson AL, Amin SB, Johnson KC, Barthel FP, Verhaak RGW, Khasraw M. Molecular and clonal evolution in recurrent metastatic gliosarcoma. Cold Spring Harb Mol Case Stud 2020; 6:mcs.a004671. [PMID: 31896544 PMCID: PMC6996521 DOI: 10.1101/mcs.a004671] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/01/2019] [Indexed: 01/25/2023] Open
Abstract
We discuss the molecular evolution of gliosarcoma, a mesenchymal type of glioblastoma (GBM), using the case of a 37-yr-old woman who developed two recurrences and an extracranial metastasis. She was initially diagnosed with isocitrate dehydrogenase (IDH) wild-type gliosarcoma in the frontal lobe and treated with surgery followed by concurrent radiotherapy with temozolomide. Five months later the tumor recurred in the left frontal lobe, outside the initially resected area, and was treated with further surgery and radiotherapy. Six months later the patient developed a second left frontal recurrence and was again treated with surgery and radiotherapy. Six weeks later, further recurrence was observed in the brain and bone, and biopsy confirmed metastases in the pelvic bones. To understand the clonal relationships between the four tumor instances and the origin of metastasis, we performed whole-genome sequencing of the intracranial tumors and the tumor located in the right iliac bone. We compared their mutational and copy-number profiles and inferred the clonal phylogeny. The tumors harbored shared alterations in GBM driver genes, including mutations in TP53, NF1, and RB1, and CDKN2A deletion. Whole-genome doubling was identified in the first recurrence and the extracranial metastasis. Comparisons of the metastatic to intracranial tumors highlighted a high similarity in molecular profile but contrasting evidence regarding the origin of the metastasis. Subclonal reconstruction suggested a parallel evolution of the recurrent tumors, and that the metastatic tumor was largely derived from the first recurrence. We conclude that metastasis in glioma can be a late event in tumorigenesis.
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Affiliation(s)
- Kevin J Anderson
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06085, USA
| | - Aaron C Tan
- Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales 2065, Australia.,National Cancer Centre Singapore, Singapore, 169610 Singapore
| | - Jonathon Parkinson
- Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales 2065, Australia.,The Brain Cancer Group, North Shore Private Hospital, St Leonards, New South Wales 2065, Australia.,The NHMRC Clinical Trials Centre, the University of Sydney, Camperdown, New South Wales 2066, Australia
| | - Michael Back
- Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales 2065, Australia.,The Brain Cancer Group, North Shore Private Hospital, St Leonards, New South Wales 2065, Australia.,The NHMRC Clinical Trials Centre, the University of Sydney, Camperdown, New South Wales 2066, Australia
| | - Marina Kastelan
- Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales 2065, Australia.,The Brain Cancer Group, North Shore Private Hospital, St Leonards, New South Wales 2065, Australia
| | - Allison Newey
- Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales 2065, Australia
| | - Janice Brewer
- Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales 2065, Australia
| | - Helen Wheeler
- Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales 2065, Australia.,The Brain Cancer Group, North Shore Private Hospital, St Leonards, New South Wales 2065, Australia.,The NHMRC Clinical Trials Centre, the University of Sydney, Camperdown, New South Wales 2066, Australia.,Bill Walsh Translational Cancer Research Laboratory, Kolling Institute of Medical Research, St Leonards, New South Wales 2065, Australia
| | - Amanda L Hudson
- Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales 2065, Australia.,The Brain Cancer Group, North Shore Private Hospital, St Leonards, New South Wales 2065, Australia.,The NHMRC Clinical Trials Centre, the University of Sydney, Camperdown, New South Wales 2066, Australia.,Bill Walsh Translational Cancer Research Laboratory, Kolling Institute of Medical Research, St Leonards, New South Wales 2065, Australia
| | - Samirkumar B Amin
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06085, USA
| | - Kevin C Johnson
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06085, USA
| | - Floris P Barthel
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06085, USA.,Department of Pathology, VU University Medical Center/Brain Tumor Center Amsterdam, Amsterdam 1081 HV, The Netherlands
| | - Roel G W Verhaak
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06085, USA
| | - Mustafa Khasraw
- Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales 2065, Australia.,The Brain Cancer Group, North Shore Private Hospital, St Leonards, New South Wales 2065, Australia.,The NHMRC Clinical Trials Centre, the University of Sydney, Camperdown, New South Wales 2066, Australia
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8
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Hsieh JK, Hong CS, Manjila S, Cohen ML, Lo S, Rogers L, Sloan AE. An IDH1-mutated primary gliosarcoma: case report. J Neurosurg 2016; 126:476-480. [PMID: 27153165 DOI: 10.3171/2016.2.jns151482] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors present the case of a primary gliosarcoma with an isocitrate dehydrogenase-1 (IDH1) mutation. A 75-year-old man presented with a 3-day history of multiple focal seizures and was found on MRI to have a 2.2-cm left parietal enhancing mass lesion. Brain MRI for tremor performed 8 years prior to this presentation was normal. En bloc resection revealed a high-grade glioma with sarcomatous components that was immunoreactive for the R132H variant of IDH1 by antibody. Gliosarcoma is a rare variant of glioblastoma that arises most frequently as a primary tumor, and has equal or worse survival and an increased propensity for extracranial metastases compared with other Grade 4 gliomas. In contrast, isocitrate dehydrogenase-1 and -2 mutations are associated with low-grade gliomas with increased survival and less commonly with glioblastoma. To the authors' knowledge, there has been only 1 other published report of a primary gliosarcoma carrying an isocitrate dehydrogenase mutation. This rare genetic-histological combination highlights potential differences between glioblastoma and gliosarcoma and may warrant additional study.
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Affiliation(s)
- Jason K Hsieh
- Case Western Reserve University School of Medicine, Cleveland.,Cleveland Clinic Lerner College of Medicine, Cleveland
| | | | - Sunil Manjila
- Department of Neurological Surgery, University Hospitals-Case Medical Center, Cleveland
| | | | - Simon Lo
- Case Western Reserve University School of Medicine, Cleveland.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland; and.,Departments of Radiation Oncology and
| | - Lisa Rogers
- Case Western Reserve University School of Medicine, Cleveland.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland; and.,Neurology, University Hospitals-Seidman Cancer Center, Cleveland, Ohio
| | - Andrew E Sloan
- Case Western Reserve University School of Medicine, Cleveland.,Department of Neurological Surgery, University Hospitals-Case Medical Center, Cleveland.,Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland; and
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