Reticulum cell sarcoma of the brain. A review of the literature and a study of 19 cases.

Reticulum cell sarcoma of the brain is a rare neoplasm. However, patients who have been recipients of transplants have had a much higher than expected incidence of this tumor; reticulum cell sarcomas of the brain may be seen more often in the future. Most of the information available in the literature deals with the pathology and clinical course of the disease. Although several authors have commented on the radioresponsiveness of the tumor, little detail as to the exact treatment methods has been provided. Furthermore, it has been assumed that the prognosis of this tumor, after some form of surgery and postoperative radiotherapy, may be fairly good. This paper presents 19 patients who have had surgery followed by postoperative radiotherapy. Although a few patients have had good relief of symptoms for 3 to 4 years, only 1 patient is alive and free of disease over 5 years. This patient is the sixth reported long-term survival in the literature. Suggestions for the management of this disease are provided. If possible, limited surgery to remove circumscribed tumors should be done, but extensive resection should be avoided. Postoperative irradiation should include the whole brain to at least 4500 rads at 1000 rads per week, with a boost to residual tumor, if present, of 500 to 1000 rads in two to five treatments.