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OLIGODENDROGLIOMA Oligodendrogliomas are uncommon Gliomas which account for approximately 4% of primary Brain tumors. These tumors arise from Glial cells, called Oligodendrocytes (the cells that are responsible for creating and maintaining myelin, which is the insulating substance around the axons of Brain cell fibre networks). They are much less common than Astrocytes. These are tumors of adults, with the peak incidence being between 35 and 45 years of age.SYMPTOMS The initial symptoms of this tumor are not specific for Oligodendroglioma. Seizures (epilepsy) are the presenting symptom in 50-80% of cases. Symptoms are more often related to local mass effect and less commonly to a generalized increase in Intracranial Pressure (ICP). These symptoms are similar to those of any intracranial mass lesion and include headaches, mental status changes, and nausea/dizziness.DIAGNOSIS Patients presenting with the above symptoms, should have an evaluation, which includes and MRI or CT scan. Oligodendrogliomas commonly have some "calcification" within them which can indicate to the Neurosurgeon that this tumor may include Oligodendroglioma cells.TREATMENT Surgery The initial treatment for Oligodendroglioma is aggressive removal. The definitive diagnosis is made by microscopic examination of the tumor tissue taken at the time of surgery.Aggressive resection of this tumor leads to longer survival, and results in fewer side effects than "partial debulking" operations. It is important to recognize that a significant percentage of Astrocytoma tumors may also have an Oligodendroglioma component as well. These tumors are called "Mixed Gliomas". Treatment of a Mixed Glioma is similar to what is described for an Astrocytoma. Most Oligodendrogliomas are slow-growing tumors. Tumor grade is the single most important prognostic variable. Patients with low-grade lesions have 5- and 10-year survival rates of 74% and 46% respectively; the rates are 41% and 20% for patients with grade 3 or 4 tumors. Chemotherapy Most Oligodendrogliomas respond to some form of chemotherapy. Newer forms of medication, such as Temodar (temozolamide) and CPT 11, as well as other agents are being used in addition to, or replacing more conventional drugs such as PCV (procarbazine, CCNU, and vincristine). Information regarding these newer treatments is available on several websites.Radiation Therapy One of our Neuro-oncologists generally recommends Radiation Therapy as an adjunct for these tumors. Benefits of postoperative radiation are somewhat controversial, since some studies have shown improved survival, while others have shown no increase in survival.Follow-up As in all cases of these "Malignant" tumors, long-term follow-up is imperative.
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All content ©2024 by Neurosurgical Consultants, P.A. Author, Martin L. Lazar, MD, FACS All Rights Reserved. See Usage Notices. |