Gliosarcoma is a rare primary malignant tumour of the central nervous system. A 28-year-old radiographer without a history of neurological disorder, malignancy or trauma presented with unprovoked seizures. He was symptom-free for 3 years but developed relapsed. Computed tomography of the brain was consistent with anaplastic convexity meningioma which was identical via intraoperative findings. However, the final histology revealed gliosarcoma of the brain. He recovered well postoperatively without any neurological deficit and had completed adjuvant chemo-radiotherapy. He was asymptomatic during follow up with no tumour recurrence. Gliosarcoma with predominant sarcomatous component mimicking a meningioma has prolonged survival as compared to a case with predominant glioblastoma component. Hence, the discordance between clinical, radiological, intraoperative and histopathological findings is a challenge in establishing a diagnosis of gliosarcoma.
Introduction:Gliosarcoma is a rare malignant brain tumor. The clinical presentation is acute with rapid progression of symptoms. Commonly affecting the elderly, it is rare to happen in youngsters. Case description: A 28-year-old radiographer presented to us with two episodes of unprovoked seizure. He denied any medical illnesses, or trauma, fall, motor vehicle accident and fever prior to these attacks. The computed tomography (CT) of brain was normal. He was managed as epilepsy and remained symptom-free for 3 years until the unprovoked seizure recurred. Another CT of brain performed and revealed a right parietal intracranial mass. This finding was supported by magnetic reso-nance imaging scan. The histologic examination showed a biphasic pattern of glial with predominant sarcomatous component giving a diagnosis of gliosarcoma of the brain. He had completed six cycles of adjuvant chemotherapy and was asymptomatic during clinic follow up with no tumor recurrence. Conclusion: Individuals with high risk of radiation exposure particularly radiographer as in our case requires a special attention when it comes to the diagnosis of malignancy. Despite of indolent clinical presentations, a close monitoring is needed to avoid mismanagement and subsequent morbidities.