We present a case of de novo fibrosarcoma in a 43-year-old male, with MRI documented evolution from a 5 mm hyperintense area
to 5 cm tumor mass in a 12-month period. The diagnosis of low-grade fibrosarcoma was established by three experienced neuropathologists.
The patient underwent gross total resection with adjuvant fractionated conformal radiotherapy. Following first recurrence
3 months later, the patient was reoperated and stereotactic radiosurgery of a residual tumor was performed thereafter. The
pathological diagnosis was similar, but with additional extensive radiation effects. Six months later the patient underwent
aggressive surgical resection for second recurrence. The pathological diagnosis was WHO grade IV glioblastoma. The etiology
of this highly unusual progression from primary mesenchymal neoplasm to high-grade glioma is discussed.
Keywords Gliomatous differentiation - Gliosarcoma - Primary cerebral fibrosarcoma - Rapid growth