Oligoastrocytoma

Oligoastrocytoma are diffusely growing glioma, that belong to the oligodendroglial tumours. These rare brain tumours are also called „mixed glioma“, since they present with an appearance of two cell origin, astrocytoma and oligodendroglioma.

 

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Histology of Oligoastrocytoma

    • no clear dissociation between oligodendroglial and astrocytic cells
    • oligoastrocytoma (WHO grade II)
    • anaplastic oligoastrocytoma (WHO grade III)

     

    Epidemiology of Oligoastrocytoma

     

    • peak age between 35 and 40
    • in childhood arround 10
    • men are a little more often affected

     

    Symptoms of Oligoastrocytoma 

     

    • mainly epileptic seizures
    • signs of cerebral pressure (headache, nausea, emesis)
    • symptoms related to localisation

     

    Diagnosing Oligoastrocytoma 

     

    • diagnosis with MRI, CT or biopsy
    • in most cases enhancement of contrast agent
    • infiltrating growth
    • sometimes metastases in liquor
    • possibly hemorrhages
    • frequently genetic defect (co-deletion of chromosomal arms 1p and 19q and TP53)
    • main localisation: cerebrum (frontal lobe, temporal lobe)

     

    Therapy of Oligoastrocytoma 

     

    • complete as possible surgical removal
    • radiotherapy after partial surgeries and for anaplastic tumours
    • chemotherapy for progressive and anaplastic tumours
    • chemotherapy also discussed for grade II tumours

     

    Therapy of Recurrent Oligoastrocytoma 

     

    • re-operation
    • second irradiation
    • chemotherpy with different agents, e.g. PCV-scheme
    • experiemental therapeutic approaches

     

    Aftercare of Oligoastrocytoma

     

    • first check-up 6 weeks after therapy (MRI with contrast agent)
    • WHO grade II: check-up every 3 months, if results are constant every 6 to 12 months
    • WHO grade III: every 3 months (MRI with contrast agent)

     

    Course of Oligoastrozytoma 

     

    • growth characteristic depends on WHO-grade
    • development from WHO grade II to WHO grade III possible
    • histological assignment often changes in recurrences
    • better response to radio- and chemotherapy when co-deletion of chromosomal arms 1p and 19q

     

    Prognosis of Oligoastrocytoma

     

    • determined by astrocytic amount of cells
    • chemo sensitivity  higher than in purely astrocytic tumours

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