A rare case of gliosarcoma: Comprehensive radiological, histopathological, and clinical insights into diagnosis and management

Gliosarcoma is a rare and aggressive variant of glioblastoma, characterized by a biphasic histological pattern consisting of both glial and mesenchymal components. This case report describes the clinical presentation, radiological findings, surgical management, and histopathological analysis of gliosarcoma in a 30-year-old female. The patient presented with a 10-day history of right-sided headache and recurrent vomiting. Neurological examination was unremarkable, and vital signs were stable. Magnetic resonance imaging (MRI) revealed a heterogeneously enhancing mass lesion involving the right parietal region and the splenium of the corpus callosum, crossing the midline and causing significant ventricular effacement. Imaging features included heterogeneously hypointense signals on T1-weighted imaging, hyperintense signals on T2/FLAIR, areas of blooming on susceptibility-weighted imaging, and restricted diffusion on diffusion-weighted imaging, suggestive of a high-grade glial tumor. The patient underwent surgical resection, and histopathological examination confirmed gliosarcoma. The tumor exhibited a biphasic pattern comprising glial and sarcomatous elements. This case emphasizes the diagnostic challenges associated with gliosarcoma, where radiological features often mimic glioblastoma, necessitating histopathological confirmation. Gliosarcoma's aggressive nature poses significant therapeutic challenges, with treatment strategies involving surgical resection followed by adjuvant radiotherapy and chemotherapy. This report highlights the importance of integrating clinical, radiological, and histopathological findings to achieve an accurate diagnosis and optimize treatment outcomes. It underscores the need for early recognition and a multidisciplinary approach to managing rare central nervous system tumors like gliosarcoma. Further research into advanced therapeutic strategies is warranted to improve the prognosis for such patients.