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| {{Infobox medical condition (new) | | |
| | name = {{PAGENAME}} | | {{Infobox medical condition |
| | synonyms =
| | | name = Anaplastic Oligodendroglioma |
| | image = Anaplastisches Oligodendrogliom, IDH-Mutationsstatus und 1p 19q Status.jpg | | | image = <!-- Image removed --> |
| | width =
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| | alt =
| | | field = [[Neuro-oncology]] |
| | caption = Anaplastic oligodendroglioma, IDH mutation and 1p 19q status | | | symptoms = [[Headache]], [[seizures]], [[neurological deficits]] |
| | pronounce = | | | onset = [[Adulthood]] |
| | specialty = [[Oncology]]
| | | duration = [[Chronic]] |
| | symptoms = | | | causes = [[Genetic mutations]] |
| | complications =
| | | risks = [[Family history]], [[radiation exposure]] |
| | onset = | | | diagnosis = [[MRI]], [[biopsy]] |
| | duration = | | | treatment = [[Surgery]], [[radiation therapy]], [[chemotherapy]] |
| | types =
| | | prognosis = [[Variable]] |
| | causes = | | | frequency = [[Rare]] |
| | risks = | |
| | diagnosis = | |
| | differential =
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| | prevention =
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| '''Anaplastic oligodendroglioma''' is a [[Neuroepithelial cell|neuroepithelial]] [[tumor]] which is believed to originate from [[oligodendrocytes]], a cell type of the [[glia]]. In the [[World Health Organization (WHO)]] classification of brain tumors, anaplastic oligodendrogliomas are classified as [[Grading (tumors)|grade]] III.<ref name=Louis2007>{{cite news|author=David N. Louis, Hiroko Ohgaki, Otmar D. Wiestler, Webster K. Cavenee, Peter C. Burger, Anne Jouvet, Bernd W. Scheithauer, Paul Kleihues | date= 6 July 2007 | title= The 2007 WHO Classification of Tumours of the Central Nervous System | pmc= 1929165 | lang=EN}}</ref> In the course of the disease, they can degenerate into WHO grade IV [[glioblastoma]].<ref name=SwissBrain>{{cite web|title=Anaplastisches Oligodendrogliom |website=www.swissbraintumorfoundation.com/ |url=http://www.swissbraintumorfoundation.com/Anaplastisches-Oligodendrogliom.htm|url-status=|format=|access-date=|archive-url=|archive-date=|last=Schweizerische Hirntumor Stiftung|date=|year=|language=de|pages=|quote=}}</ref> The vast majority of oligodendrogliomas occur sporadically, without a confirmed cause and without [[heredity|inheritance]] within a family.
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| == Pathogenesis ==
| | '''Anaplastic oligodendroglioma''' is a rare and aggressive type of [[brain tumor]] that originates from [[oligodendrocytes]], which are cells in the [[central nervous system]] responsible for producing [[myelin]]. This tumor is classified as a [[World Health Organization]] (WHO) grade III [[glioma]], indicating a high degree of malignancy. |
| The ([[malignant]]) anaplastic oligodendroglioma belongs to the group of [[Diffusion|diffuse]] [[glioma]] and arises in the [[central nervous system]] ([[brain]] and [[spinal cord]]) from [[Precursor cell|precursor]] [[stem cell]]s of the [[oligodendrocyte]]s.This tumor occurs primarily in middle adulthood with a frequency peak in the 4th and 5th decade of life.<ref name=SwissBrain/>
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| | == Symptoms == |
| | Patients with anaplastic oligodendroglioma may experience a variety of symptoms depending on the tumor's location and size. Common symptoms include: |
| | * [[Headache]] |
| | * [[Seizures]] |
| | * [[Neurological deficits]] such as [[weakness]], [[numbness]], or [[speech difficulties]] |
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| | == Causes == |
| | The exact cause of anaplastic oligodendroglioma is not well understood, but it is believed to involve [[genetic mutations]]. Common genetic alterations associated with this tumor include co-deletion of [[chromosomes 1p and 19q]] and mutations in the [[IDH1]] or [[IDH2]] genes. |
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| == Diagnosis == | | == Diagnosis == |
| The most important [[diagnostic]] procedure is [[magnetic resonance imaging]] (MRI).<ref name=SwissBrain/> Occasionally, outside of routine diagnostics, the [[metabolism]] in the [[Tissue (biology)|tissue]] is shown using [[positron emission tomography]] (PET). The diagnosis is confirmed by a fine tissue examination following an operation. Anaplastic oligodendrogliomas often show a loss of genetic material. About 50 to 70%<ref name=mutant>{{cite news|author=administrador | date= 5 February 2020 | url=https://operativeneurosurgery.com/doku.php?id=anaplastic_oligodendroglioma_idh-mutant_1p_19q-codeleted | title= Anaplastic oligodendroglioma, IDH-mutant & 1p/19q-codeleted | lang=EN}}</ref> of WHO grade III anaplastic oligodendrogliomas have combined [[allele]] losses on the short arm of [[chromosome]] 1 (1p) and the long arm of chromosome 19 (19q).
| | Diagnosis of anaplastic oligodendroglioma typically involves imaging studies such as [[magnetic resonance imaging]] (MRI) to assess the tumor's location and characteristics. A [[biopsy]] is often performed to obtain a tissue sample for histological examination and genetic testing. |
| This change is mostly referred to as "1p / 19q Co Deletion". It can be seen as favorable for the patient and makes a response to radiation or chemotherapy more likely.<ref name=SwissBrain/> The designation of grade III oligodendroglioma (high grade) generally subsumes the previous diagnoses of anaplastic or malignant oligodendroglioma.<ref name=Louis2007/>
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| <gallery class="center" mode=packed heights=200px>
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| Anaplastic oligodendroglioma (1).jpg|Histopathological image of anaplastic oligodendroglioma in cerebrum. Hematoxylin & eosin stain.
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| Anaplastic oligodendroglioma (3).jpg|Zooming, note the irregular cell- and nucleus-shapes
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| </gallery>
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| == Treatment== | | == Treatment == |
| Surgery can help reduce symptoms caused by the tumor. As complete as possible removal of the tumor visible on the MRI is preferred, provided the location of the tumor allows this. Since the cells of an anaplastic oligodendroglioma have already migrated into the surrounding healthy brain tissue at the time of diagnosis, a complete surgical removal of all tumor cells is not possible. The "1p / 19q Codeletion" marker plays an increasingly important role in the selection of therapy and therapy combinations.
| | Treatment options for anaplastic oligodendroglioma may include: |
| Because of the indolent nature of this tumor and the potential [[morbidity]] associated with [[neurosurgery]], [[chemotherapy]] and [[radiation therapy]], most [[oncology|neurooncologists]] will initially pursue a course of [[watchful waiting]] and treat patients symptomatically. Symptomatic treatment often includes the use of [[anticonvulsants]] for seizures and [[Glucocorticoid|steroids]] for [[oedema|brain swelling]]. For further treatment, radiation or chemotherapy with temozolomide or a chemotherapy with [[Procarbazine]], [[Lomustine|CCNU]] and [[Vincristine]] (PCV) has been shown to be effective and was the most commonly used chemotherapy regimen used for treating anaplastic oligodendrogliomas.<ref name=SwissBrain/><ref>{{cite journal |vauthors=Engelhard HH, Stelea A, Mundt A |title=Oligodendroglioma and anaplastic oligodendroglioma: clinical features, treatment, and prognosis |journal=Surg Neurol |volume=60 |issue=5 |pages=443–56 |date=November 2003 |pmid=14572971 |doi=10.1016/s0090-3019(03)00167-8 |url=}}</ref>
| | * [[Surgical resection]] to remove as much of the tumor as possible |
| | * [[Radiation therapy]] to target remaining cancerous cells |
| | * [[Chemotherapy]] with agents such as [[temozolomide]] or [[procarbazine, lomustine, and vincristine]] (PCV) regimen |
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| == Prognosis == | | == Prognosis == |
| 5–Year relative survival rate: Age 20–44, 71%. Age 45–54, 61%. Age 55–64, 46%.<ref>{{cite news |url=https://www.cancer.org/cancer/brain-spinal-cord-tumors-adults/detection-diagnosis-staging/survival-rates.html#references |authors=Ostrom QT, Gittleman H, Xu J, et al. CBTRUS statistical report: Primary brain and other central nervous system tumors diagnosed in the United States in 2009-2013. ''Neuro Oncol''. 2016;18 Suppl 5:v1−v75. |title=Survival Rates for Selected Adult Brain and Spinal Cord Tumors |date=November 7, 2017}}</ref> Procarbazine, lomustine and vincristine have been used since May 1975. For 45 years, new therapeutic options have been regularly tested as part of therapy studies to improve the treatment of anaplastic oligodendroglioma. <ref>{{cite news |authors=P H Gutin, C B Wilson, A R Kumar, E B Boldrey, V Levin, M Powell, K J Enot |title=Phase II Study of Procarbazine, CCNU, and Vincristine Combination Chemotherapy in the Treatment of Malignant Brain Tumors |date=1 May 1975|pmid = 1122488}}</ref>
| | The prognosis for patients with anaplastic oligodendroglioma varies based on factors such as the extent of surgical resection, genetic profile of the tumor, and response to treatment. Tumors with 1p/19q co-deletion generally have a better prognosis. |
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| == Research== | | == See also == |
| {{As of|2020}}, a definitive cure is not possible with anaplastic oligodendrogliomas of [[WHO]] grade III. A retrospective study on 1054 patients with anaplastic oligodendroglioma, presented during the 2009 ASCO Annual Meeting, suggests that PCV therapy maybe efficacy. Median time to progression for patients with 1p19q co-deletion was longer following PCV alone (7.6 years) than with temozolomide alone (3.3 years); median overall survival was also longer with PCV treatment versus [[temozolomide]] treatment (not reached, vs. 7.1 years).<ref name=doi-10-1200>{{cite journal|last1=Lassman|first1=A. B.|title=Retrospective analysis of outcomes among more than 1,000 patients with newly diagnosed anaplastic oligodendroglial tumors|journal=Journal of Clinical Oncology|date=20 May 2009|volume=27|issue=15S|pages=2014|doi=10.1200/jco.2009.27.15_suppl.2014 |issn=0732-183X}}</ref> A recent long-term study does affirm that radiation combined with adjuvant chemotherapy is significantly more efficacious for anaplastic oligodendroglioma patients with 1p 19q co-deleted tumors and has become the new standard of care.<ref>{{Cite web | url=http://www.ascopost.com/issues/july-1-2012/new-standard-of-care-for-anaplastic-oligodendroglial-tumors-with-1p19q-codeletions.aspx |title = New Standard of Care for Anaplastic Oligodendroglial Tumors with 1p/19q Codeletions – the ASCO Post}}</ref> It is possible that radiotherapy may prolong the overall time to progression for non-deleted tumors. If the tumor mass compresses adjacent brain structures, a [[neurosurgery|neurosurgeon]] will typically remove as much of the tumor as he or she can without damaging other critical, healthy brain structures. Recent studies suggest that radiation does not improve overall survival (even when age, clinical data, histological grading, and type of surgery are considered).<ref>{{cite journal |vauthors=Sunyach MP, Jouvet A, Perol D, etal |title=Role of exclusive chemotherapy as first line treatment in oligodendroglioma |journal=J. Neurooncol. |volume=85 |issue=3 |pages=319–28 |date=December 2007 |pmid=17568995 |doi=10.1007/s11060-007-9422-3 }}</ref><ref>{{cite journal |vauthors=Mohile NA, Forsyth P, Stewart D, etal |title=A phase II study of intensified chemotherapy alone as initial treatment for newly diagnosed anaplastic oligodendroglioma: an interim analysis |journal=J. Neurooncol. |volume=89 |issue=2 |pages=187–93 |date=September 2008 |pmid=18458821 |doi=10.1007/s11060-008-9603-8 }}</ref>
| | * [[Oligodendroglioma]] |
| | * [[Glioblastoma]] |
| | * [[Brain tumor]] |
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| == References == | | == References == |
| {{reflist}}
| | <references /> |
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| {{Nervous tissue tumors}}
| | == External links == |
| | * [American Brain Tumor Association](https://www.abta.org/) |
| | * [National Cancer Institute](https://www.cancer.gov/) |
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| [[Category:Brain_tumor]] | | [[Category:Brain tumors]] |
| [[Category:Cancer]] | | [[Category:Neuro-oncology]] |
| [[Category:Types of cancer]]
| | [[Category:Rare diseases]] |
| [[Category:Oncology]] | |
| {{dictionary-stub1}}
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Anaplastic oligodendroglioma is a rare and aggressive type of brain tumor that originates from oligodendrocytes, which are cells in the central nervous system responsible for producing myelin. This tumor is classified as a World Health Organization (WHO) grade III glioma, indicating a high degree of malignancy.
Symptoms
Patients with anaplastic oligodendroglioma may experience a variety of symptoms depending on the tumor's location and size. Common symptoms include:
Causes
The exact cause of anaplastic oligodendroglioma is not well understood, but it is believed to involve genetic mutations. Common genetic alterations associated with this tumor include co-deletion of chromosomes 1p and 19q and mutations in the IDH1 or IDH2 genes.
Diagnosis
Diagnosis of anaplastic oligodendroglioma typically involves imaging studies such as magnetic resonance imaging (MRI) to assess the tumor's location and characteristics. A biopsy is often performed to obtain a tissue sample for histological examination and genetic testing.
Treatment
Treatment options for anaplastic oligodendroglioma may include:
Prognosis
The prognosis for patients with anaplastic oligodendroglioma varies based on factors such as the extent of surgical resection, genetic profile of the tumor, and response to treatment. Tumors with 1p/19q co-deletion generally have a better prognosis.
See also
References
<references />
External links
