Related Subjects:
|Brain tumours
|Astrocytomas
|Brain Metastases
|Tuberous sclerosis
|Turcot's syndrome
|Lhermitte Duclos Disease
|Oligodendroglioma
|Acute Hydrocephalus
|Intracranial Hypertension
|Primary CNS Lymphoma (PCNSL)
|Astrocytomas
|Glioblastoma
A more treatable form of Glioma
🧠 About
- Oligodendroglioma is a relatively more indolent glioma compared to astrocytomas or glioblastomas.
- Arises most commonly in the cerebral hemispheres — especially the frontal and temporal lobes.
- Because of its slower growth and well-demarcated margins, it is often more amenable to treatment.
🧬 Aetiology
- Less infiltrative behaviour compared with other gliomas, making surgical resection more feasible.
- Classically associated with 1p/19q co-deletions, which predict both better prognosis and greater chemotherapy sensitivity.
- Mutations in IDH1/2 are also commonly seen and improve survival outlook.
⚕️ Clinical Features
- Symptoms mirror those of other intracranial tumours:
- 💥 Seizures (often the first presentation in up to 70%).
- 🤕 Headache (due to raised ICP).
- 🧍♂️ Focal neurological deficits depending on tumour site (e.g. weakness, aphasia).
- Slow-growing — symptoms may evolve insidiously over months to years before diagnosis.
🔎 Investigations
- MRI brain: Typically shows a well-defined lesion; calcifications are common and highly suggestive.
- Stereotactic biopsy: Often required for histological confirmation.
- Genetic testing: Essential to assess for 1p/19q co-deletions and IDH mutations → guides prognosis and therapy.
💊 Management
- WHO Grade II oligodendroglioma: Median survival ~7–8 years.
- WHO Grade III (Anaplastic): Median survival ~5 years.
- Surgery: First-line where feasible. Tumours are often amenable to gross total resection.
- Chemotherapy: Particularly effective in 1p/19q co-deleted tumours (classically with PCV regimen: Procarbazine, CCNU, Vincristine).
- Radiotherapy: Used for higher-grade or residual/recurrent disease, often in combination with chemotherapy.
📌 Teaching Tip
- Always think “seizures in a young adult with calcified frontal lobe lesion” → oligodendroglioma until proven otherwise.
