<% strPathPics = Session("strPathPicsL") imgBg = strPathPics + Session("strMedia") %> OligodendrogliomaAstro

Case 10 - Mixed Oligodendroglioma / Astrocytoma

A 31 year-old man presented with headaches and focal seizures affecting the right side of his body.

Show the Tumor on T1     Show the Gadolinium Enhancement

Low Grade Glioma. (Left) T2-weighted axial MRI; (Middle) T1-weighted axial MRI; (Right) T1-weighted with gadolinium axial MRI. Note the large tumor that partially enhances with gadolinium (Gad). It arises from the posterior medial temporal/occipital lobe and spreads into the lateral ventricles. The lesion was biopsied but was difficult to classify and grade since it had features of both an astrocytoma and oligodendroglioma.

Low-grade gliomas make up 15% of all primary intracranial brain tumors, and usually occur in young adults. They are named according to the specific type of glial cell that they derive from, and include astrocytomas, oligodendrogliomas, ependymomas, and mixed gliomas such as oligoastrocytomas that contain a mixture of different types of glial cells. Although biopsy is required to make a definitive diagnosis, the lack of contrast enhancement favors the diagnosis of a low grade glioma rather than a glioblastoma. Certain genetic conditions are predisposed to the formation of gliomas (e.g., neurofibromatosis, tuberous sclerosis). Clinical signs and symptoms depend on location. Headache and focal (or focal to generalized) seizures are common. Focal neurological deficits can occur.

The World Health Organization scheme for grading gliomas from benign to progressively more malignant is as follows:

● Grade I - Pilocytic
● Grade II - Low-grade
● Grade III - Anaplastic
● Grade IV - Glioblastoma multiforme

Pilocytic tumors are very benign histologically and typically occur in children. Low-grade tumors can be slow growing and controlled by surgical resection. If they recur, they are usually higher grade tumors. Anaplastic tumors are malignant tumors with mitoses and nuclear atypia.


Revised 11/29/06.
Copyrighted 2006. David C Preston