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Anaplastic oligodendroglioma is a neuroepithelial tumor with different dignities, which is believed to originate from the oligodendrocytes, a cell type of the glia. In the World Health Organization (WHO) classification of brain tumors, anaplastic oligodendrogliomas are classified as grade III. In the course of the disease, they can degenerate into WHO grade IV glioblastoma. The vast majority of oligodendrogliomas occur sporadically, without a confirmed cause and without inheritance within a Family.

Overview

The (malignant) anaplastic oligodendroglioma belongs to the group of diffuse gliomas and arises in the central nervous system (brain and spinal cord) from precursor Stem cells of the oligodendrocytes.

This tumor occurs primarily in middle adulthood with a frequency peak in the 4th and 5th decade of life, (approx. 0.11 / 100,000 new cases per year ).

Diagnostic

The most important diagnostic procedure is magnetic resonance imaging (MRI). Occasionally, outside of routine diagnostics, the metabolism in the 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 60% 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). 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.

Therapy

Tissue removal during an operation serves to confirm the diagnosis of anaplastic oligodendroglioma. In addition, 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. Therefore, further treatment is always necessary after an operation. Radiation and chemotherapy with temozolomide or a combination of procarbazine, lomustine and vincristine (PCV scheme) are suitable for the after-treatment. The "1p / 19q Codeletion" marker plays an increasingly important role in the selection of therapy and therapy combinations. In addition to the standard methods, new therapeutic options are regularly being tested as part of therapy studies in order to improve the treatment of anaplastic oligodendroglioma.

Course and forecast

A definitive cure is not possible with anaplastic oligodendrogliomas of WHO grade III. Compared to astrocytomas of the same WHO grade, the course is more favorable. Around 40–50% of patients survive for more than 5 years.

References

1. Schweizerische Hirntumor Stiftung. "Anaplastisches Oligodendrogliom". www.swissbraintumorfoundation.com/ (in German).
2. www.cbtrus.org

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