Gliosarcoma: a rare variant of glioblastoma multiforme

Gliosarcoma (GS) is a rare malignant neoplasm of the central nervous system. It is a variant of glioblastoma multiforme (GBM) consisting of both glial and sarcomatous components. This is a case of a 51-year-old, right-handed male with a history of recurrent GS, despite multiple resections, radiation therapy, and multiple rounds of chemotherapy. The patient first presented with sudden loss of comprehension, hallucinations, and aphasia. Magnetic resonance imaging (MRI) showed a left posterior parietal lobe lesion. He underwent a craniotomy with resection, postoperative radiation and chemotherapy. GBM has a high rate of recurrence, and in the two years following diagnosis, the tumour increased in size on six occasions. Over this time period, the patient underwent multiple rounds of surgery, chemotherapy, and radiation treatments. The patient survived for approximately three years after his first presentation. Currently, the treatment of newly diagnosed GBM patients includes temozolomide chemotherapy in combination with radiation therapy. Ongoing clinical trials have also shown bevacizumab to be a useful agent in patients with recurrent GBM. The prognosis following a diagnosis of GBM has recently improved due to the introduction of drugs such as temozolomide and bevacizumab. However, the outlook is still poor. Mean survival for GBM patients with standard-of-care surgery, radiation therapy, and chemotherapy is 15 months. The rate of recurrence is high, and the treatment required is aggressive.