title: Histologically repeatedly confirmed gliosarcoma with long survival: review of the literature and report of a case.
abstract: OBJECTIVE
  A rare case of gliosarcoma in a 61-year-old woman is presented with a stable situation over 22 years with an excellent quality of life.
  
  
  METHODS
  The patient was initially symptomatic and was operated on in 1975 for a deep-seated left parietal gliosarcoma. During the following 20 years, she was clinically asymptomatic until she complained of increasing headache in 1995. Neuroradiological imaging showed a sharply demarcated lesion on MRI at the former operative site, which was operated on again. Four months later, the residual tumour did grow again.
  
  
  METHODS
  As radiation therapy could not stop tumour progression and the neurological status worsened, the patient was operated on again for a massive tumour mass in the left parieto-occipital region, filling out nearly all of the previous resection cavity. Despite radio-immunotherapy, the patient finally died 22 years after the first discovery of the tumour.
  
  
  CONCLUSIONS
  The present case shows that, in rare instances, gliosarcomas may show prolonged survival, although the underlying pathogenetic mechanisms for this clinical behaviour are not understood.
authors.affiliation: Department of Neurosurgery, and Institute of Legal Medicine, Ludwig-Maximilians University, Munich, Germany.
authors.forename: P A
authors.initials: PA
authors.lastname: Winkler
authors.forename: A
authors.initials: A
authors.lastname: Büttner
authors.forename: A
authors.initials: A
authors.lastname: Tomezzoli
authors.forename: S
authors.initials: S
authors.lastname: Weis
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D017809:Fatal Outcome; D005260:Female; D018316:Gliosarcoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery; D009778:Occipital Lobe / Q000473:pathology; D010296:Parietal Lobe / Q000473:pathology; D012008:Recurrence; D012086:Reoperation