{"id":"a96a0e18-47a3-4377-84fc-3d336cdbfe6a","slug":"idh1-mutant-primary-intraventricular-gliosarcoma-case-report-and-systematic-review-of-a-rare-location-and-molecular-profile","title":"IDH1-mutant primary intraventricular gliosarcoma: Case report and systematic review of a rare location and molecular profile","authors":["Leonardo Jose Monteiro de Macedo Filho","Esther Grangeiro Barreto","Paulo Levi Bezerra Martins","Euler Nicolau Sauaia Filho","Gunter Gerson","Lucas Alverne Freitas de Albuquerque"],"abstract":"Background: Gliosarcoma (GS) is classified as an IDH-wild-type variant of glioblastoma (GBM). While GS is already an unusual presentation of GBM, IDH1-mutant cases are especially rare. We present an IDH1-mutant primary intraventricular GS case report and a systematic review of the molecular profile in GS correlating to the prognostic and pathogenesis of IDH1/2 mutations. Case Description: A 44-years-old man presented with ongoing fatigue symptoms and a new-onset intense occipital headache. The patient complained of memory loss, dyscalculia, and concentration difficulties. An MRI revealed a bihemispheric intraventricular mass crossing the midline through the corpus callosum and infiltrating the trigone of the lateral ventricles, hypointense, and hyperintense on the T1- and T2-weighted image. We performed a microsurgical resection with a transparietal transsulcal approach; however, the contralateral mass was attached to vascular structures and we decided to reoperate the patient in another moment. The histopathological study showed a Grade IV tumor and the immunohistochemistry confirmed the diagnosis of GS. The patient presented progressive neurologic decline and died 45 days after the surgical approach. Conclusion: We did two systematic reviews studies from PubMed, EMBASE, MEDLINE, Cochrane, and SCOPUS databases, and included molecular and intraventricular studies of GS. We performed further meta-analysis using OpenMetaAnalyst™ software. We conducted a forest plot with the molecular profile of GS. When correlated IDH1 mutation versus tp53 mutation, we found an odds ratio (OR) of 0.018 (0.005–0.064) and P P = 0.006; OR = 0.138 [0.034–0.562]). The studies evaluating the molecular profile in GS prognostics are often extended from all GBMs despite specifics GBM variants (i.e., GS). We found a correlation between IDH1 mutation expression with tp53 and MGMT expression in GS, and future studies exploring this molecular profile in GS are strongly encouraged.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/a96a0e18-47a3-4377-84fc-3d336cdbfe6a/featured/hero-1781563000975.png","publishDate":"2020-11-06T00:00:00.000Z","doi":"10.25259/SNI_586_2020","categories":["Neuro-oncology","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2020/11/10377/SNI-11-372.pdf"}