UC Irvine

NovoTTF treatment is an FDA approved treatment strategy for recurrent Glioblastoma multiforme (GBM) management which employs alternating electric fields to the region of the malignant tumor through probes on the patient's head which is thought to improve time to disease progression of GBM via cell cycle mitosis disruption. A patient is described with recurrent GBM who had disease progression following initial standard surgical treatment and concomitant chemo-radiotherapy and was found to have sarcomatous transformation after initiation of NovoTTF-100A electrical device therapy with bevacizumab. Upon tumor progression, less than two years after initial diagnosis, the patient underwent surgical resection which revealed transformation from a GFAP-positive WHO grade IV astrocytoma into a GFAP-negative, reticulin-positive sarcoma with rhabdomyoid features following histopathological evaluation. The possibility of a causal connection between the NovoTTF therapy and sarcomatous transformation needs to be further evaluated. No such case of sarcoma progression in the CNS following chemo-radiotherapy and/or electrical current treatment for Glioblastoma multiforme has been reported in the literature.