Unique Case Report of a Meningeal Sarcoma Arising during Ongoing Treatment for Progressing Intraparenchymal Glioma

Abstract EN

Radiation-induced sarcomas in the brain are extremely rare, usually occur with an average latency of 9 years, and are associated with poor outcomes.

Latency periods shorter than 1 year may indicate a genetic predisposition such as Li-Fraumeni syndrome.

A 34-year-old man underwent initial tumor resection and radiation therapy for a World Health Organization (WHO) Grade II Astrocytoma.

Within 6 months, the tumor recurred as WHO Grade III and was treated with temozolomide and then bevacizumab.

Despite the patient’s apparent improving condition, MRI revealed new dural-based lesions 10 months after radiation therapy and identified as high-grade sarcoma.

The patient resumed bevacizumab, began NovoTTF treatment for progressing glioma, and ifosfamide/doxorubicin for the sarcoma.

Genetic testing revealed no pathogenic mutation in the TP53 gene.

Ultimately, treatment was unsuccessful and the patient succumbed to glioma and sarcoma within 2 years of initial diagnosis.

This case was unique due to the rapidly progressing glioma and sudden appearance of a high-grade sarcoma.

It is unusual to have two separate intracranial primary cancers with each requiring a different chemotherapy regimen.

We discuss the difficulty of simultaneously treating with separate chemotherapy regimens.

It remains unclear whether the sarcoma was induced by the radiation treatment or a genetic predisposition.