Secondary gliosarcoma with extra-cranial metastases: a report and review of the literature.

ABSTRACT

OBJECTIVE: To describe a unique case of secondary gliosarcoma (SGS) with widespread extra-cranial metastases that developed more than 5 years after the initial diagnosis of glioblastoma multiforme (GBM). This interval is the longest among the cases reported to date. METHODS: A PUBMED search using the key words "secondary gliosarcoma" and "extra-cranial metastases" was performed followed by a review of cited literature. RESULTS: Including our report, we found 44 cases of SGS, of which only 5 developed extra-cranial metastases. CONCLUSION: SGS with extra-cranial metastases is extremely rare. Of previously reported cases, the longest survival was 2 months after the diagnosis of SGS. The present case had a survival of 6.5 months. Our case highlights the importance of screening for extra-cranial metastases in SGS. The optimal treatment of SGS is not known and strategies based on GBM and sarcoma treatments have been employed with limited success. A combination of treatment modalities may extend survival as in the present report; however the prognosis remains poor.