title: Metastatic brain sarcoma with gliomatous component.
abstract: Here we report a metastatic brain carcinosarcoma from the uterus that posed a problem on diagnosis by containing an extensive gliomatous component. A 56-year woman developed motor aphasia 3 months after hysterectomy for a uterine tumor. Magnetic resonance imaging (MRI) demonstrated a left frontal cystic tumor, which was treated by stereotactic radiosurgery. The lesion recurred 5 months later and was resected. Histological examination demonstrated neoplastic cells that were positive for glial fibrillary acidic protein (GFAP), leading to the diagnosis of high-grade glioma. This lesion recurred again after 9 months, and was resected again. The tumor tissue mostly consisted of GFAP-positive gliomatous cells, but close examination identified a sarcomatous component compatible with the metastatic lesion from the uterine sarcoma. This sarcoma component contained GFAP-negative-CD10-positive cells and GFAP-positive-CD10-negative cells. There was no clear border between those components, and, therefore, the lesion was considered to be a metastatic tumor from the uterus showing extensive neural differentiation. Although rare, uterine tumors are known to show such neural differentiation, and the histological diagnosis in such cases can be challenging.
authors.affiliation: Department of Neurosurgery, Dokkyo University School of Medicine, Mibu, Tochigi 321-0293, Japan.
authors.forename: Fumi
authors.initials: F
authors.lastname: Higuchi
authors.forename: Hadzuki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Okada
authors.forename: Phyo
authors.initials: P
authors.lastname: Kim
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ueki
mesh_terms: D014408:Biomarkers, Tumor; D001932:Brain Neoplasms / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D005910:Glioma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012509:Sarcoma / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D014594:Uterine Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; D005904:Glial Fibrillary Acidic Protein