title: A case of an anaplastic ependymoma with gliosarcomatous components.
abstract: A 29-year-old woman presented with a severe headache. Computed tomography revealed a large cystic lesion with a mural nodule-like mass homogeneously enhanced with contrast medium in the right cerebellum. The tumor was removed, and pathological studies revealed a cerebellar astrocytoma corresponding to World Health Organization grade II. When she was 35 years old, or 6 years after the surgery, magnetic resonance imaging revealed a recurrence of the tumor in the right cerebellum, and subtotal removal of the recurrent tumor was performed. Pathological studies revealed a mixed glioblastoma multiforme and anaplastic ependymoma. Chemotherapy (Paraplatin and VePeside-S) and focal radiation therapy at 60 Gy were administered following surgery. Thereafter, at 39 years of age, or 4 years after radiation therapy, magnetic resonance imaging again revealed a recurrence of the tumor, which was heterogeneously enhanced with gadoliniumdiethylenetriamine pentaacetic acid in the right cerebellum. Subtotal removal of the tumor was performed; pathological studies revealed an anaplastic ependymoma with sarcomatous components. Immunohistochemical findings showed some parts of the sarcomatous components to stain positively for glial fibrillary acidic protein and, as a result, these sarcomatous components were diagnosed to be gliosarcoma.
authors.affiliation: Department of Neurosurgery, Fukaya Red Cross Hospital, 5-8-1 Kamishibanishi, Fukaya, Saitama 366-0052, Japan. gm100078-2328@tbe.t-com.ne.jp
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kano
authors.forename: Hayato
authors.initials: H
authors.lastname: Ikota
authors.forename: Hirochiyo
authors.initials: H
authors.lastname: Wada
authors.forename: Susumu
authors.initials: S
authors.lastname: Iwasa
authors.forename: Shuhei
authors.initials: S
authors.lastname: Kurosaki
mesh_terms: D000328:Adult; D001254:Astrocytoma / Q000473:pathology / Q000601:surgery; D002528:Cerebellar Neoplasms / Q000473:pathology* / Q000601:surgery; D004806:Ependymoma / Q000473:pathology* / Q000601:surgery; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D018316:Gliosarcoma / Q000473:pathology* / Q000601:surgery; D006261:Headache / Q000209:etiology; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local; D016612:Paraffin Embedding; D014057:Tomography, X-Ray Computed
chemical_list: D005904:Glial Fibrillary Acidic Protein