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Gliosarcoma is one of the many types of brain tumor affecting people from all over the world. Know all about the causes, symptoms and possible treatment options of the condition.
What is Gliosarcoma?
Gliosarcoma or GS is a very rare form of glioma, a type of brain cancer which occurs from the glial brain cells instead of the neural brain cells. This malignant cancer is defined to be a Glioblastoma comprising of sarcomatous and gliomatous components. The main characteristic feature of this histological variant of GBM (Glioblastoma multiforme) is a typical biphasic tissue pattern, having alternate areas of mesenchymal and glial differentiation. According to the WHO (World Health Organization) classification, Gliosarcoma corresponds to the Grade IV astrocytoma.
The symptoms of GS generally have their onset between the ages of 52 years and 55 years. Males are two times more at risk of developing the tumors compared to women. It usually does not affect children.
This is a hereditary disorder. The genetic structure of sufferers is often believed to be mainly responsible for this clinical condition. Missing or mutated genes lead to this abnormality in brain cells. The abnormal cells eventually form tumor by multiplying many times.
Picture 1 – Gliosarcoma
Some research indicates that GS can also occur because of exposure to radiation.
The symptoms of this disease may vary according to the location of the tumor. The most common signs include the following:
- Recurring headaches
- Vision loss
- Cognitive problems
- Personality changes
The diagnosis of this disorder is done on the basis of a specific biphasic tissue pattern made up of 2 different malignant cell populations: a Gliomatous (which fulfills all criteria for Glioblastoma) and malignant mesenchymal differentiation (which fulfills all criteria for a sarcoma). The following tests are used for making this diagnosis:
The tumors can be detected by CT. They are visible as sharply defined, lobule or round hyperdense solid mass. It may show comparatively homogeneous contrast enhancement along with peri-tumoral edema.
This test shows a mixed pial and dural vascular supply. It helps to diagnose GS by detecting premature cortical venous drainage, prominent vascular stain and irregular tumor vessels along with well-defined tumor margins.
MRI (Magnetic Resonance Imaging)
It is a useful imaging test which helps a diagnostician to detect this brain tumor before it progresses to an advanced stage.
Gliosarcoma Vs Glioblastoma
The term Gliosarcoma is applied in cases where a sarcomatous element can be evidently detected, while Glioblastoma (GBS) is considered to be the highest-grade tumor in spectrum of the diffusely infiltrating astrocytic neoplasms. Various subtypes are known including fibrillary (most common), gemistocytic, granular cell, small cell and giant cell forms. The sarcomatous component in GS generally assumes the form of pleomorphic or fibrosarcoma spindle cell sarcoma.
Picture 2 – Gliosarcoma Image
The two disorders have certain distinctions that help to differentiate between them. According to certain large clinical trials, however, there are no significant differences in the procedure used for making their prognosis. The survival rates associated with these conditions are similar as well.
The incidence of GS is 1.8–2.8% of that of GBS.
Gliosarcoma Treatment and Management
Various treatment options are used for fighting this form of brain cancer. The treatment procedure depends on the location and severity of the tumor. This treatment generally comprises of surgery, radiation therapy and chemotherapy. The tumor can be removed surgically if its location is favorable for performing a removal surgery. Generally, this surgery is followed by chemotherapy. Various chemicals and medications are used in chemotherapy for killing the cancer cells. Some research suggests that drugs like Temozolomide and Bevacizumab (Avastin) can be use for treating GS. Immunotoxin therapy is another useful treatment option used for this purpose.
There is a lack of proper information regarding the prognosis or outcome of the treatment. Various studies are being conducted to find out the possible outcome for patients with the disorder. Delayed treatment or leaving the tumors untreated can turn fatal in severe cases. The tumors have high risk of recurrence within 9 months to 13 months after the treatment completes.
There is no known way of preventing the occurrence of the inherited form of the cancerous tumor as the exact causes that trigger the genetic mutation leading to the cell abnormality are unknown. Scientists are carrying out various researches and tests to find out whether it can be prevented.
One can take certain preventive measures to keep the radiation-induced form of the disorder from occurring. For this reason, doctors advice to keep the amount of radiation exposure as low as possible. This includes the number of x-rays and similar procedures performed on a certain individual. People with professions involving radiation exposure should always wear protective gear.
Gliosarcoma is a rare but potentially life threatening condition requiring early diagnosis and timely treatment. Proper management allows patients to have a normal life expectancy. Sufferers and their family members can get in touch with several forums and support groups which provide guidelines about ways to manage and cure the disease.