[Gliosarcoma--a case report].

UNLABELLED: A 60-year-old woman was admitted to our clinic on September 29, 1983 because of a five months history of personality change and progressive left sided motor weakness. Neurological examination on admission revealed left hemiparesis and papilledema. She was severely demented. Skull X-rays were normal. CT scan showed a large right parietoccipital mass which was markedly enhanced by contrast medium. Right internal carotid angiogram showed abnormal vascular shadow, early draining veins and tumor stain in parietoccipital region. Right external carotid angiogram showed that the tumor was partly fed by the middle meningeal artery in "sunburst" pattern. The tumor was resected subtotally through right parietoccipital craniotomy on October 4, 1983. At operation, well demarcated, reddish-grey tumor attached to the dura was found. Several branches of the middle meningeal artery were penetrated into the tumor through the attachment. The tumor grossly appeared to be a meningioma in its superficial part, but demarcation was found being obscured in removing the deeper part of the tumor.

PATHOLOGICAL FINDINGS: The specimens obtained from the superficial part of the tumor showed admixture of two distinctive neoplastic tissues. One was malignant mesenchymal features. Fibrosarcomatous nature was obvious, characterized by cells with moderately chromatic, fusiform nuclei arranged in parallel rows and eosinophilic fibers deeply stained in silver preparation for reticulin. The other was gliomatous tissue forming islands surrounded by the sarcomatous tissues. Both tissues were histologically malignant, as evidenced by mitotic figure, high cellularity, atypical features and variability. In deeper part, sarcomatous findings was less noticed and features of glioblastoma multiforme more prominent, characterized by marked astrocytic anaplasia, endothelial proliferation and extensive perinecrotic pseudopalisading.(ABSTRACT TRUNCATED AT 250 WORDS)