title: Rapid growth of primary cerebral fibrosarcoma with conversion to glioblastoma at second recurrence.
abstract: We present a case of de novo fibrosarcoma in a 43-year-old male, with MRI documented evolution from a 5 mm hyperintense area to 5 cm tumor mass in a 12-month period. The diagnosis of low-grade fibrosarcoma was established by three experienced neuropathologists. The patient underwent gross total resection with adjuvant fractionated conformal radiotherapy. Following first recurrence 3 months later, the patient was reoperated and stereotactic radiosurgery of a residual tumor was performed thereafter. The pathological diagnosis was similar, but with additional extensive radiation effects. Six months later the patient underwent aggressive surgical resection for second recurrence. The pathological diagnosis was WHO grade IV glioblastoma. The etiology of this highly unusual progression from primary mesenchymal neoplasm to high-grade glioma is discussed.
authors.affiliation: Department of Neurosurgery, Hadassah - Hebrew University Medical Center, POB 12000, 91120, Jerusalem, Israel.
authors.forename: Amos Olufemi
authors.initials: AO
authors.lastname: Adeleye
authors.forename: Yakov
authors.initials: Y
authors.lastname: Fellig
authors.forename: Felix
authors.initials: F
authors.lastname: Umansky
authors.forename: Yigal
authors.initials: Y
authors.lastname: Shoshan
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005354:Fibrosarcoma / Q000473:pathology* / Q000628:therapy; D005909:Glioblastoma / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016609:Neoplasms, Second Primary / Q000473:pathology* / Q000628:therapy; D019635:Neurosurgical Procedures; D016634:Radiosurgery; D020266:Radiotherapy, Conformal