Clinical features, pathology, and prognostic factors for oligodendroglial tumors
- Martin van den Bent, MD, PhD
Martin van den Bent, MD, PhD
- Daniel den Hoed Oncology Center
- Neuro-Oncology Unit
- Section Editors
- Patrick Y Wen, MD
Patrick Y Wen, MD
- Section Editor — Neurooncology
- Professor of Neurology
- Harvard Medical School
- Jay S Loeffler, MD
Jay S Loeffler, MD
- Section Editor — Neurooncology
- Professor of Radiation Oncology
- Harvard Medical School
There are significant differences between oligodendrogliomas and oligoastrocytomas and other glial tumors in pathology, molecular pathogenesis, and natural history. These differences have important prognostic implications, which can affect treatment.
The clinical manifestations, classification, pathologic classification, and molecular prognostic factors associated with oligodendroglial tumors will be reviewed here. The treatment of these tumors is discussed separately. (See "Management of anaplastic oligodendroglial tumors".)
Clinical features — The presenting signs and symptoms of oligodendroglial tumors are nonspecific and depend upon the location and extent of the tumor. Symptoms may be either generalized (eg, headaches, seizures, cognitive dysfunction) or focal (eg, weakness, sensory abnormalities, aphasia). There are no clinical features that distinguish these tumors from other gliomas. (See "Clinical presentation and diagnosis of brain tumors".)
Most oligodendroglial tumors arise in the white matter of the cerebral hemispheres, predominantly in the frontal lobes . However, they can also arise at infratentorial sites and in the spinal cord. As with other glial tumors, oligodendrogliomas and oligoastrocytomas only rarely metastasize outside the central nervous system.
Epidemiology — Oligodendroglial tumors constitute between 5 and 20 percent of all glial tumors. The frequency of these lesions is higher in contemporary reports due primarily to modifications in subjective histopathologic criteria, but more recently the presence of more classical histopathologic features for this diagnosis is emphasized .
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- CLINICAL MANIFESTATIONS
- Clinical features
- Genetic abnormalities
- Recommendations for molecular testing
- PROGNOSTIC FACTORS
- Clinical factors
- Histopathologic correlations
- Molecular markers
- - Co-deletion of 1p/19q
- - IDH1 mutations
- - MGMT methylation
- - Chromosome 10q loss