Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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April 18, 2016
Anaplastic Oligodendroglioma
- Background:
- WHO grade III glial tumor – Increased mitotic activity differentiates this case from WHO grade II oligodendroglioma.
- Oligodendroglial neoplasms represent 5–18% of gliomas. Twenty to 54% of oligodendrogliomas are anaplastic.
- Clinical Presentation:
- Typically seen in men in the 6th to 7th decade of life
- Seizure is the most common presenting symptom.
- Key Diagnostic Features:
- Frontal and temporal lobe predominant intra-axial primary glial neoplasms
- Poor contrast enhancement
- May have cystic degeneration, hemorrhage, calcification
- Up to 90% demonstrate calcifications
- Differential Diagnosis:
- Astrocytoma: Most common intra-axial mass and can have calcifications
- Meningioma Most common extra-axial mass and often densely calcified
- Supratentorial ependymoma: 40–80% have calcifications
- Glioblastoma
- PNET (in younger patients)
- Treatment:
- Surgery plus-or-minus chemotherapy (surgery alone in young patients)
- 1p/19q chromosome deletions strongly associated with improved prognosis