MS-08GLIOSARCOMA: FEATURES AND OUTCOMES IN A TERTIARY CARE HOSPITAL IN PAKISTAN

INTRODUCTION: Gliosarcoma is a rare CNS neoplasm with a few cases reported from Pakistan. OBJECTIVES: We aim to see the features and outcomes of this rare entity in Pakistan. METHODS: A retrospective case-series conducted at the Department of Neurosurgery, Aga Khan University. The medical record files of surgically treated patients with Gliosarcoma from 2003 - 2012 were reviewed, MRI/C.T scans and Histopathological slides were reviewed. Patients lost to follow-up were contacted. Analysis was done on SPSS 20. RESULTS: A total of 7 cases of Gliosarcoma were found. The median age was 52 years with a male:female of 5:2. The symptoms included Headache 71%, hemiparesis 43%, dysphasia, forgetfulness and dysphagia 29% patients. KPS was >70 in 4 and <70 in 3 patients. Five patients had tumor in Temporal lobe. MRI showed Hypointense signals in 2, iso-intense in 2 and hypo-iso-intense signals in 2 cases on T1-weighted images and hyperintense in 5 cases on T2-weighted images. Solid tumor was seen in 5 patients, features of necrosis was seen in 4,hemorrhage in 3 cases. Mass effect was seen in 3 cases. Contrast enhancement was seen in 6 cases. Gross-total resection was done in 3, Sub-total resection in 2 cases and biopsy in 2 cases. Recurrence was found in 6 patients. Repeat surgery was done in 3 patients, 6 underwent chemo + radiotherapy. Six patients died of the disease. The median Progression Free Survival was 2 months (range 1-6 months), median Overall survival was 6 months (3- 13 months). CONCLUSION: Gliosarcoma is a significantly aggressive tumor in Pakistan.