두개강내 역형성 성상세포종의 신경교육종으로 전환 -증례보고- = Transformation of Intracranial Anaplastic Astrocytoma into Gliosarcoma -Case Report-

다국어 초록 (Multilingual Abstract)

Gliosarcoma is a rare biphasic central nervous system malignancy that are composed of distinct sarcomatous and glial neoplastic proportion. We report a rare case with transformation of recurrent anaplastic astrocytoma into gliosarcoma. A 26-year-old male patient presented with headache. He was diagnosed as neurofibromatosis type I, 5 years ago. Magnetic resonance image(MRI) showed a well-demarcated, heterogeneously enhancing space-occupying lesion in the right frontal lobe. He underwent an osteoplastic craniotomy with radical tumor resection. Histopathology of tumor showed heterogeneous pleomorphic nuclear hyperchromatism corresponding with anaplastic astrocytoma. He was taken radiotherapy and chemotherapy. Subsequent follow-up period of 11 months was uneventful until he developed a generalized tonic clonic seizure, along progressively worsening headache. MRI showed tumor recurrence in the right frontal lobe. Re-exploration was carried out and gross total resection was done. Pathological examination displayed a biphasic pattern of glial and sarcomatous component suggesting gliosarcoma. This is an uncommon case with transformation of anaplastic astrocytoma into gliosarcoma, and we discussed with pertinent literatures.