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Axial MRI of Gliosarcoma
Tumor Class Astrocytoma
Cell of origin Glial
WHO Grade IV
Survival 6 Months
Treatment Surgery, Radiation, Chemotherapy
Histologic Features
Radiographic Features



Gliosarcoma is a histological variant of Glioblastoma multiforme (GBM) characterized by a biphasic tissue pattern with alternating areas of glial and mesenchymal differentiation. Gliosarcoma corresponds to WHO Grade IV astrocytoma.


Gliosarcoma accounts for about 2% of all GBMs. The mean age of occurrence is 53 years. There is a male predominance (1.8:1).


Gliosarcomas are most often supratentorial, occurring in descending frequency in the temporal, frontal, parietal and occipital lobes.

Clinical presentation

Most patients present with new-onset seizure or paresis.


Angiographic examination demonstrates a mixed dural and pial vascular supply. On MRI, these lesions may be mistaken for a meningioma or hemangiopericytoma.

Photomicrograph of gliosarcoma showing biphasic pattern of glial and sarcomatous components.


Gliosarcomas are biphasic lesions composed of a firm, sarcomatous component, often located superficially, and a more typical gliomatous component.


A biphasic tissue pattern displaying gliomatous and mesenchymal (e.g. neoplastic spindle cells imbedded in a reticulin-positive stroma) components is necessary for diagnosis.

Molecular genetics

Gliosarcomas possess a complement of molecular mutations similar to those seen in GBMs (see Molecular genetics of Gliomagenesis), but generally lack evidence of EGFR amplification of overexpression.


Large trials have failed to demonstrate a difference in outcomes for gliosarcoma and GBM.

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