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Case Reports
. 2017 Apr;6(2):89-94.
doi: 10.2217/cns-2016-0035. Epub 2017 Mar 17.

Case of glioblastoma patient treated with tumor treating fields therapy at recurrence degenerating to sarcoma

Pejman Majd  1 , Daniel E O'Connell  2 , Ronald C Kim  2 , Daniela A Bota  2 , Jose A Carrillo  2
Affiliations
Case Reports

Case of glioblastoma patient treated with tumor treating fields therapy at recurrence degenerating to sarcoma

Pejman Majd et al. CNS Oncol. 2017 Apr.

Abstract

Optune® treatment is a US FDA-approved treatment for glioblastoma (GBM) that employs alternating electric fields. Tumor treating field (TTF) therapy can exert its effects on GBM via cell cycle mitosis disruption and cytokinesis. We describe a patient with recurrent GBM who had disease progression following standard surgical treatment and concomitant chemoradiotherapy, and was found to have sarcomatous transformation after initiation of TTF therapy with bevacizumab. Upon tumor progression, repeat surgical resection revealed transformation into a GFAP-negative, reticulin-positive sarcoma with rhabdomyoid features. The possibility of a causal connection between TTF therapy and sarcomatous transformation needs to be further evaluated. No such case of apparent sarcoma formation in the CNS following chemoradiotherapy and/or TTF treatment for GBM has been reported.

Keywords: Optune®; glioblastoma; glioma; recurrence; sarcoma; tumor treating fields.

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Conflict of interest statement

Financial & competing interests disclosure

JA Carrillo is a consultant for NovoCure. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Figures

<b>Figure 1.</b>
Figure 1.. Pre-operative MRI T1 axial with gadolinium contrast.
MRI showing typical contrast enhancement pattern in GBM prior to surgery.
<b>Figure 2.</b>
Figure 2.
(A) Necrosis with pseudopalisading, Hematoxylin and eosin (H&E) stain at 10x. (B) Pink astrocyte, H&E stain at 40x.
<b>Figure 3.</b>
Figure 3.. T1 axial with gadolinium contrast showing right temporo-parietal progression with dural involvement.
MRI with enhancing progression with new dural extension of disease.
<b>Figure 4.</b>
Figure 4.
(A) H&E stain at 10x. (B) Reticulin stain at 10x.
<b>Figure 5.</b>
Figure 5.. GFAP Immunohistochemistry stain at 10x.
See this image and copyright information in PMC

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