oligodendroglioma, IDH-mutant and 1p/19q-codeleted, grade 3

Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, Grade 3: A High-Grade Tumor

Oligodendrogliomas are a type of brain tumor that can be classified into two grades based on their characteristics. The grade 3 oligodendroglioma, also known as anaplastic oligodendroglioma, is a more aggressive form of this tumor.

Key Features:

• IDH mutation and 1p/19q codeletion: Like other oligodendrogliomas, grade 3 oligodendrogliomas have the same genetic markers (IDH mutation and 1p/19q codeletion) [5].
• High-grade tumor: Grade 3 oligodendrogliomas are a more aggressive form of this tumor, with a higher rate of progression and recurrence compared to grade 2 oligodendrogliomas [9].
• Diffusely infiltrating glial neoplasm: Grade 3 oligodendrogliomas are characterized as diffusely infiltrating glial neoplasms, which means they can spread throughout the brain tissue [3].

Diagnosis and Treatment:

• Surgery: Surgery is used to establish a diagnosis and relieve symptoms due to mass effect in patients with suspected diffuse glioma, including grade 3 oligodendrogliomas [4].
• Histopathologic features: Tumors continue to be categorized as either grade 2 (low-grade) or grade 3 (anaplastic) based on histopathologic features [8].

References:

[1] Oligodendrogliomas are grouped into two grades (grade 2 or grade 3) based on their characteristics. [3] Oligodendroglioma, IDH mutant and 1p/19q codeleted is a diffusely infiltrating glial neoplasm with IDH1 or IDH2 mutation and 1p / 19q whole ... [4] Aug 28, 2024 — Surgery provides tissue to establish the diagnosis and is used to relieve symptoms due to mass effect in patients with suspected diffuse ... [5] The information in this page is based on the ... oligodendroglioma, IDH mutant and 1p/19q co-deleted ... grade 3 (high grade), sometimes called anaplastic. [8] Aug 28, 2024 — Tumors continue to be categorized as either grade 2 (low-grade) or grade 3 (anaplastic) oligodendroglioma based on histopathologic features.

Common Signs and Symptoms

Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, grade 3 can present with a variety of symptoms, depending on the location of the tumor in the brain. Some common signs and symptoms include:

• Headaches: A frequent or severe headache is one of the most common symptoms of oligodendroglioma, IDH-mutant and 1p/19q-codeleted, grade 3 [5].
• Seizures: Seizures can occur due to the tumor's impact on brain function [9].
• Personality changes: Changes in personality or behavior may be noticed by family members or friends [9].
• Weakness or numbness: Weakness or numbness in an arm or leg can occur if the tumor is located near the spinal cord or a major nerve [7].

Other Possible Symptoms

In addition to these common symptoms, other possible signs and symptoms of oligodendroglioma, IDH-mutant and 1p/19q-codeleted, grade 3 may include:

• Focal neurologic deficits: Weakness or numbness in a specific area of the body can occur if the tumor is located near a major nerve [10].
• Cognitive or mental status changes: Changes in cognitive function or mental status can occur if the tumor is located in an area critical for these functions [10].

Important Note

It's essential to seek immediate medical attention if you experience any of these symptoms, as prompt diagnosis and treatment are crucial for effective management of oligodendroglioma, IDH-mutant and 1p/19q-codeleted, grade 3.

References:

[5] Symptoms · Seizures · Headaches · Personality changes. · Other symptoms may also be noted including persistent weakness or numbness in an arm or leg or changes ...

[7] Oligodendroglioma symptoms usually depend on where the tumour is located in the brain, but could include the sensation of strange smells or muscular weakness.

[9] Symptoms · Seizures · Headaches · Personality changes. · Other symptoms may also be noted including persistent weakness or numbness in an arm or leg or changes ...

[10] Other common presenting symptoms: headache, focal neurologic deficits or cognitive / mental status change, depending on anatomic location ... are compatible with anaplastic oligodendroglioma, IDH mutant and 1p / 19q codeleted, WHO grade 3 ...

Diagnosing Oligodendrogliomas: A Comprehensive Overview

Oligodendrogliomas are a type of brain tumor that requires precise diagnostic testing to confirm the presence of specific genetic alterations. The diagnosis of oligodendroglioma involves finding two key genetic changes: an IDH mutation and a 1p/19q codeletion.

Key Diagnostic Tests for Oligodendroglioma

• IDH Mutation Testing: This test is essential in diagnosing oligodendrogliomas. The presence of an IDH mutation is a hallmark of this type of tumor.
• 1p/19q Codeletion Test: This test assesses the co-deletion status of the 1p and 19q chromosomes, which is a diagnostic marker for oligodendroglioma.

Additional Diagnostic Markers

• ATRX and TP53 Status: These molecular markers can also help in assessing the tumor's behavior and predicting the best treatment response.
• Genetic/Molecular Testing: This comprehensive testing evaluates various genetic and molecular markers to confirm the diagnosis of oligodendroglioma.

Implications for Treatment and Prognosis

The presence of both IDH mutation and 1p/19q codeletion in oligodendrogliomas has significant implications for treatment and prognosis. These tumors tend to have a better prognosis compared to other types of brain tumors, and the diagnostic tests mentioned above play a crucial role in confirming this diagnosis.

References

• [1] The presence of IDH mutation is a hallmark of oligodendroglioma (Source: 2)
• [3] According to the WHO classification for central nervous system tumors, the diagnosis of an oligodendroglioma requires the presence of both an IDH mutation and a 1p/19q codeletion (Source: 3, 7)
• [4] Assessment of 1p/19q co-deletion, together with IDH mutation status and other molecular markers, can help in predicting the best treatment response (Source: 4)
• [8] Oligodendrogliomas are defined by their 1p/19q-codeletion and IDH mutation (Source: 8)

Treatment Options for Oligodendroglioma

Oligodendrogliomas are a type of brain tumor that can be treated with surgery, radiation therapy, and chemotherapy. The treatment approach depends on the tumor's location, size, and grade.

• Surgery: The first line of treatment for oligodendroglioma is surgery, if possible. The goal of surgery is to obtain tissue to determine the tumor type and extent (1). Maximal resection is the preferred approach, but depending on the location and extent of the tumor, a partial resection may be necessary (4).
• Radiation Therapy: Radiation therapy is often used in combination with chemotherapy for oligodendrogliomas. The standard treatment for grade 3 IDH-mutant glioma is adjuvant therapy with radiation therapy followed by temozolomide or procarbazine, lomustine, and vincristine (PCV) (9).
• Chemotherapy: Chemotherapy may be used in combination with radiation therapy to treat oligodendrogliomas. The ongoing CODEL phase III trial evaluates the effectiveness of chemotherapy in treating IDH-mutant gliomas (5).

Current Guidelines

According to current guidelines, people with oligodendroglioma, IDH-mutant, 1p19q codeleted, CNS WHO grade 3 should be offered radiation therapy in combination with PCV (6). However, the optimal treatment approach may vary depending on individual factors.

References

• [1] Aug 28, 2024 — Surgery provides tissue to establish the diagnosis and is used to relieve symptoms due to mass effect in patients with suspected diffuse ...
• [3] Aug 20, 2024 — The first treatment for an oligodendroglioma is surgery, if possible. The goal of surgery is to obtain tissue to determine the tumor type and ...
• [4] Aug 28, 2024 — As with other gliomas, maximal resection is the preferred approach for oligodendrogliomas, but depending upon the location and extent of the ...
• [5] by RA Nasany · 2023 · Cited by 23 — The ongoing CODEL phase III trial evaluates newly-diagnosed patients with IDH mutant, 1p/19q co-deleted gliomas grades 2 and 3, and compares ...
• [6] by NA Mohile · 2022 · Cited by 130 — People with oligodendroglioma, IDH-mutant, 1p19q codeleted, CNS WHO grade 3 should be offered radiation therapy (RT) in combination with PCV (Type: evidence ...
• [9] by MD Lin · 2024 — For patients with grade 3 IDH-mutant glioma, adjuvant therapy with RT followed by TMZ or PCV is generally used for all patients. Institutional ...

The differential diagnosis for an oligodendroglioma that is IDH-mutant and 1p/19q-codeleted, grade 3 involves considering other entities that may present with similar genetic features.

• Diffuse leptomeningeal glioneuronal tumor (DLGT): This rare entity can show combined 1p/19q codeletion, making it a potential differential diagnosis for oligodendroglioma. However, DLGT typically presents as a diffuse process rather than a well-circumscribed mass [10].
• Astrocytomas: Presurgical differentiation between astrocytomas and oligodendrogliomas remains an unresolved challenge in neuro-oncology. While both entities can share similar genetic features, the presence of IDH mutation and 1p/19q codeletion is more specific to oligodendroglioma [3][8].
• Other gliomas: The differential diagnosis for oligodendroglioma also includes other types of gliomas that may present with similar histological or molecular features. However, the presence of IDH mutation and 1p/19q codeletion is a key feature that helps to distinguish oligodendroglioma from these other entities.

It's worth noting that the diagnosis of oligodendroglioma requires finding two genetic alterations: an IDH mutation and a very specific change in the tumor cells' genetic material, specifically 1p/19q codeletion [1]. The presence of these features is essential for making a definitive diagnosis of oligodendroglioma.

References: [1] Aug 20, 2024 — Diagnosing an oligodendroglioma requires finding two genetic alterations: an IDH mutation and a very specific change in the tumor cells' ... [3] by A Pons-Escoda · 2024 · Cited by 3 — Presurgical differentiation between astrocytomas and oligodendrogliomas remains an unresolved challenge in neuro-oncology. [8] by A Pons-Escoda · 2024 · Cited by 3 — Presurgical differentiation between astrocytomas and oligodendrogliomas remains an unresolved challenge in neuro-oncology. [10] by LY Ballester · 2018 · Cited by 1 — The other entity in the differential diagnosis is diffuse leptomeningeal glioneuronal tumor (DLGT), which very rarely can show combined 1p/19q codeletion (