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Oligodendroglioma - Symptoms, Diagnosis, and Treatment

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Oligodendroglioma is a diffuse infiltrating glioma that makes up around five percent of all primary cerebral tumors. Read the article to know more.

Medically reviewed by

Dr. Rajesh Gulati

Published At December 13, 2022
Reviewed AtFebruary 23, 2024

What Is Oligodendroglioma?

Oligodendroglioma is a primary central nervous system (CNS) tumor involving the brain and spinal cord. They are most frequently observed in the frontal lobes and affect the cortical gray tissue. Approximately five percent of initial intracranial tumors are oligodendrogliomas.

How Do Oligodendrogliomas Develop?

Bailey and Bucy gave oligodendrogliomas their original name in 1929 as they resembled a type of cell found in the central nervous system (oligodendrocytes). Oligodendrocytes are brain cells that nourish and insulate nerve fibers of the central nervous system. Oligodendrogliomas are found in the white matter and the cortex, the brain's outer layer. The tumors appear to develop from neural progenitor (type of brain cells) cells with glial (brain cells) precursors and resemble oligodendrocytes.

Why Do Oligodendrogliomas Develop?

Cancer is a genetic disease; specific mutations to the genes that regulate cells cause this disease. Mutations of the genes cause an increase in cancer cells. An increased risk of developing oligodendrogliomas relates to radiation exposure or specific gene mutations in family history.

What Is the Incidence of Oligodendrogliomas?

  • Although they can happen at any age, oligodendrogliomas most frequently affect adults between the ages of 35 and 44.

  • Males are more likely to develop oligodendrogliomas than females.

What Are the Grades of Oligodendroglioma?

The primary tumors of the central nervous system are categorized according to the patient's age and the type, size, and extent of cancer. The characteristics of oligodendrogliomas divide them into two classes:

1. Grade II-

  • They are low-grade tumors that develop slowly and infiltrate surrounding healthy tissue.

  • They frequently develop years before being recognized since there are no symptoms.

2. Grade III-

  • They are malignant Grade III oligodendrogliomas.

  • Therefore, they rapidly expand and spread to other body parts.

  • They are also known as anaplastic oligodendrogliomas.

How Is an Oligodendroglioma Diagnosed?

1. Biopsy-

  • A biopsy on a small tissue removed during surgery ensures an accurate diagnosis.

  • A neuropathologist would provide a precise analysis of the tumor tissue.

2. Magnetic Resonance Imaging-

  • Oligodendrogliomas present as a single tumor with distinct borders and considerable swelling surrounding the cancer.

  • Anaplastic oligodendrogliomas are the most common type.

Which Tissues Do the Oligodendrogliomas Invade?

Oligodendrogliomas can spread throughout the central nervous system through cerebrospinal fluid (CSF). Rarely do oligodendrogliomas spread to other organs outside the central nervous system.

What Signs and Symptoms Are Present in Oligodendroglioma?

Depending on the tumor's location, the symptoms of oligodendroglioma may vary. These signs and symptoms might manifest as

  1. Seizures.

  2. Headaches.

  3. Issues with memory and thought.

  4. Weakness.

  5. Numbness.

  6. Imbalance and mobility issues.

What Is the Prognosis of Oligodendrogliomas?

Oligodendroglioma has a relative five-year survival rate of 74.1 %; the prognosis can be affected by various circumstances. Practitioners must inform this cancer's characteristics according to the patient's age and health and advise suitable therapy.

What Is the Differential Diagnosis for Oligodendroglioma?

1. Astrocytoma-

  • The primary differential diagnosis based on imaging is a diffuse astrocytoma, essentially identical to oligodendroglioma.

  • On imaging, diffuse astrocytoma frequently has less dystrophic calcification, more white matter, and less cortical involvement than oligodendroglioma.

  • However, they can be differentiated from oligodendroglioma by the absence of the 1p/19q deletion (type of chromosome alteration) in astrocytomas.

2. Glioblastoma-

  • Glioblastoma is a crucial diagnostic factor of oligodendroglioma.

  • They often have restricted diffusion patches and central necrosis areas, rare in oligodendroglioma.

  • Calcification is highly prevalent in oligodendroglioma but rare in glioblastoma.

3. Dysembryoplastic Neuroepithelial Tumors (DNET)-

  • It is a low-grade subcortical neoplasm that resembles oligodendrogliomas.

  • They tend to have a more bubbly cystic appearance and may have surrounding cortical dysplasia.

  • Oligodendrogliomas are more frequently identified in older persons, whereas dysembryoplastic neuroepithelial tumors (DNET) are found in children and young adults.

4. Ganglioglioma-

  • Another subcortical tumor that is more common in children and young adults and can cause seizures is ganglioglioma.

  • On an MRI, gangliogliomas often appear as a cyst with an enhancing nodule and are more frequently found in the temporal lobe than in oligodendrogliomas.

5. Multinodular and Vacuolating Neuronal Tumor (MVNT)-

  • A subcortical lesion commonly manifests as a collection of tiny bubbly cysts that do not usually enhance. They are discovered by chance and maybe a malformation or dysplastic lesion rather than an actual tumor.

What Are the Treatments Options for Oligodendroglioma?

1. Surgery-

  • Surgery is the first line of defense against an oligodendroglioma.

  • It aims to acquire tissue to identify the type of tumor and remove as much cancer as feasible without increasing the patient's symptoms.

  • The type of surgery chosen is based on the tumor's location, the patient's age, or any potential risks.

  • Resection is the preferred course of treatment.

  • Repeat surgical resection is still recommended to cure patients with low-grade tumors that have been partially removed and show increased tumor growth over time or in patients at risk for developing higher-grade neoplasms.

2. Radiotherapy-

  • After surgical resection, radiotherapy is frequently used to treat oligodendroglioma.

  • Early postoperative radiotherapy has been associated with an improved time to progression and better seizure control after surgery.

  • Hyperfractionated standard-focused or limited-field radiation therapy is frequently used.

  • The dose delivered recommendations of 45-65 Gy in 1.8-2 Gy segments.

  • Depending on the prognosis, dosage and timing are case-specific.

  • Hypofractionated doses, which deliver single fractions for the same or lower total amount, may be used in older patients with a worse prognosis.

3. Chemotherapy-

  • It is a frequently used adjunct with radiation therapy (RT) or alone.

  • The use of Procarbazine, Lomustine, and Vincristine (PCV) are used in combination to treat oligodendroglioma.

  • However, this regimen usually is only used for six cycles due to unfavorable side effects.

  • Temozolomide (TMZ) is the treatment of choice to avoid adverse effects.

  • Using novel chemotherapy, targeted therapy, or immunotherapy medications is also available.

Conclusion:

Oligodendroglioma is a diffuse infiltrating glioma that makes up around five percent of all primary cerebral tumors. The healthcare team chooses the patient's treatments based on the patient's age, the amount of tumor that remains after surgery, the type of tumor, and the location of the cancer. Although oligodendroglioma is a low-grade tumor, it can cause significant morbidity. Older persons in their fourth and fifth decades are most frequently affected by oligodendroglioma. Early detection and thorough surgical removal improve outcomes and have a considerably better prognosis.

Frequently Asked Questions

1.

Can Oligodendroglioma Cancer Be Cured?

The chances of curing oligodendroglioma cancer depend on several factors, such as the tumor's stage and location, the patient's age and health, and the response to treatment. While a complete cure is not always possible, treatment options such as surgery, radiation therapy, and chemotherapy can help to control the tumor's growth and alleviate symptoms, potentially leading to remission or extended survival.

2.

Are Oligodendroglioma Tumors Cancerous in Nature?

Yes, Oligodendroglioma tumors are cancerous. They are a type of brain tumor originating in the cells that produce a fatty substance called myelin, which protects nerve cells in the brain. Oligodendrogliomas are classified as grade II or III tumors based on their cellular characteristics and how rapidly they grow.

3.

Is Oligodendroglioma a Fatal Type of Cancer?

Oligodendroglioma can be fatal, but it depends on various factors such as the tumor's location, grade, and the patient's age and overall health. While low-grade oligodendrogliomas have a relatively better prognosis and can be treated with surgery, radiation, and chemotherapy, high-grade tumors are more aggressive and difficult to treat, often leading to a poorer prognosis.

4.

What Category of Tumor Is an Oligodendroglioma?

Oligodendroglioma is a type of primary brain tumor originating from oligodendrocytes, which are the cells responsible for producing the insulating myelin sheath surrounding nerve fibers in the central nervous system. It falls under the category of gliomas, which are tumors that arise from glial cells - the supportive cells of the brain.

5.

What Is the Average Lifespan of Patients with Oligodendroglioma?

Patients with oligodendroglioma's survival rate depends on factors like the tumor grade, location, size, and treatment response. Patients with low-grade tumors usually have a better prognosis and higher survival rates than those with high-grade tumors. The average survival for grade II oligodendroglioma is around 10-15 years, while it is 3-5 years for grade III tumors. Proper treatment and management can lead to long-term survival and potential cures.

6.

Which Brain Tumor Is Considered the Most Deadly?

Glioblastoma multiforme (GBM) is considered the most deadly brain tumor due to its rapid growth and high recurrence rate. It is a highly aggressive cancer with a median survival of approximately 12-15 months, even with aggressive treatment.

7.

Do People Survive Oligodendroglioma?

People can survive oligodendroglioma, but the prognosis depends on several factors such as the tumor grade, size, location, and the patient's overall health. Low-grade oligodendrogliomas have a better prognosis and can be treated with surgery, radiation, and chemotherapy, while high-grade tumors are more aggressive and difficult to treat. Survival rates vary widely based on the tumor grade, but early detection and prompt treatment can improve the chances of survival.

8.

Who Is the Longest Surviving Patient with Oligodendroglioma?

There is one patient with an oligodendroglioma located in the left temporal lobe and third ventricle. This patient has managed to survive for 40 years since the onset of symptoms and underwent the first craniotomy 39 years ago. Currently, the patient is still alive and leading a healthy life.

9.

How Quickly Does an Oligodendroglioma Grow?

Generally, these tumors are slow-growing and may take years to reach a significant size. However, high-grade oligodendrogliomas can grow rapidly and become aggressive. Close monitoring and regular imaging tests are necessary to track the progression of the tumor and determine the appropriate treatment plan.

10.

Is Oligodendroglioma Caused by Genetic Factors?

Oligodendroglioma can be caused by genetic factors, but the exact causes are not well understood. Mutations in specific genes, particularly the 1p and 19q genes, have been strongly associated with the development of oligodendroglioma. The development of oligodendroglioma is believed to be influenced by a combination of genetic and environmental factors.

11.

At What Point Is Brain Cancer Treatable?

Brain cancer is most treatable when detected early, prior to its spread to other regions of the brain or the body. Treatment options are surgery, radiation therapy, and chemotherapy, among others. However, even in cases where the cancer has advanced or has spread, treatment options may still be available to help manage symptoms and extend the patient's life.

12.

Can Brain Tumors Be Completely Cured?

 
Some brain tumors can be completely cured with surgery, radiation therapy, and/or chemotherapy, others may require long-term treatment and management. Additionally, some brain tumors may not be curable, but treatments can help control the growth and spread of the tumor, alleviate symptoms, and improve the patient's quality of life.

13.

Which Type of Brain Tumor Is Incurable?

Many types of brain tumors are considered incurable, including diffuse intrinsic pontine glioma (DIPG), glioblastoma multiforme (GBM), and anaplastic astrocytoma. These tumors spread rapidly and are challenging to treat due to their location in the brain and their tendency to spread quickly. While treatments can help manage symptoms and extend life, a complete cure for these types of tumors is currently not possible with available therapies.

14.

What Is the Most Challenging Brain Tumor to Remove Surgically?

Tumors located in certain areas of the brain, such as the brainstem, cerebellum, or areas close to vital structures, can be particularly difficult to remove safely. High-grade tumors such as glioblastomas and metastatic brain tumors also tend to be more challenging to remove completely. The surgical approach and techniques used by the neurosurgeon can also affect the difficulty of the surgery.
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Dr. Rajesh Gulati
Dr. Rajesh Gulati

Family Physician

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