[Intracerebrally localized sarcoma NOS--an interdisciplinary challenge].
BACKGROUND
In the literature, surveys of malignant intracerebral nerve sheath tumors are very rare (Table 1). Therapeutic guidelines do not exist.


METHODS
A 28-year-old female patient presented with a tumor in the postcentral region of the left parietal lobe (Figures 1 and 2). The specimen could not be categorized into a common tumor entity and was classified as sarcoma NOS. Shortly after surgery, a recurrence occurred (Figures 3 to 5) followed by a further excision. Due to the rapid tumor growth irradiation with CT-aided treatment planning (Figure 6) has been started immediately afterwards. A dose of 5,400 cGy in 22 fractions was administered.


RESULTS
2 weeks after treatment, the patient presented with a noticeable tumor regression (magnetic resonance imaging; Figures 7 to 9). She developed pulmonary metastases. A partial remission could be achieved by systemic chemotherapy. Unfortunately, the patient died because of an exacerbation of a hepatic encephalopathy.


CONCLUSIONS
In cases of intracerebrally localized sarcomas NOS, the earliest possible start of radiotherapy after surgery seems useful because of the noticed radiosensitivity of these tumors. In regard of the local control, this tumor entity shows a documented excellent response to radiotherapy. Expectedly, distant metastases cannot be influenced. Interdisciplinary cooperation is mandatory to enhance the diagnostic process, the treatment decisions, and the results.
Holzmeister
Roswitha
R
Abteilung für Radioonkologie, Krankenhaus Barmherzige Schwestern, Sellerstätte 4, 4010 Linz, Austria. roswitha.holzmeister@bhs.at
Schindler
Christoph
C
Aichholzer
Martin
M
Pichler
Josef
J
Trenkler
Johannes
J
Spiegl
Kurt
K
Hammer
Josef
J
D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D016371:Cranial Irradiation; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018319:Neurofibrosarcoma / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D010296:Parietal Lobe; D010348:Patient Care Team; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant; D019233:Retreatment