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Oligodendroglioma is a rare brain tumor originating from oligodendrocytes, glial cells that produce myelin in the central nervous system. It represents 2-5% of primary brain tumors and 5-18% of gliomas, typically affecting the cerebral hemispheres (frontal/temporal lobes). Graded as low (II, slow-growing) or anaplastic (III, aggressive), it’s characterized by 1p/19q codeletion (90% of cases) and IDH mutations, making it more responsive to therapy than other gliomas. In 2025, ~1,000 US cases annually, median age 40-50, slightly more in men, with seizures as common presentation.
Symptoms depend on tumor location and growth rate: seizures (70-90% of cases, often focal), headaches, cognitive changes (memory loss, personality alterations), weakness/paralysis (hemiparesis), sensory loss, visual field defects, and speech difficulties. Low-grade tumors cause gradual symptoms over years, while grade III progresses faster with increased intracranial pressure (nausea, vomiting). Symptoms mimic stroke or migraines.
Causes are unknown, but genetic alterations (IDH1/2 mutations in 80%, 1p/19q codeletion) drive growth. Risk factors include radiation exposure and hereditary syndromes (e.g., Li-Fraumeni), but no strong environmental/lifestyle links. In 2025, research shows epigenetic changes and tumor microenvironment promote progression from grade II to III.
Diagnosis uses MRI (showing well-demarcated, calcified masses with minimal edema), CT for calcifications (50-90% of cases), and biopsy/resection for histopathology (fried-egg cells). Molecular testing confirms 1p/19q codeletion and IDH status. EEG assesses seizures, with PET/MR spectroscopy aiding grading. In 2025, AI enhances MRI for codeletion prediction.
Treatment involves maximal safe resection (improving survival), followed by observation for low-grade or PCV chemotherapy (procarbazine, lomustine, vincristine) + radiation for grade III. Temozolomide is alternative for chemo. In 2025, vorasidenib (IDH inhibitor) extends progression-free survival by 11 months in IDH-mutant gliomas.
In 2025, 5-year survival is 80% for grade II, 50% for grade III. Codeleted/IDH-mutant tumors have better prognosis (15-year survival 70%). IDH inhibitors like vorasidenib transform low-grade management. By 2030, vaccines and immunotherapy could raise survival to 90% for grade II, 70% for III.
The information for oligodendroglioma is drawn from Cleveland Clinic’s “Oligodendroglioma: Symptoms, Treatment & Prognosis” for symptoms and treatment; Mayo Clinic’s “Oligodendroglioma – Symptoms and causes” for causes; American Brain Tumor Association’s “Oligodendroglioma” for understanding; NCI’s “Oligodendroglioma Diagnosis and Treatment” for diagnosis; Cancer Research UK’s “Oligodendroglioma | Cancer Research UK” for research; National Brain Tumor Society’s “Oligodendroglioma | National Brain Tumor Society” for outlook; OncoDaily’s “Oligodendroglioma: Causes, Symptoms, Diagnosis, and Treatments” for diagnostic methods; UCLA Health’s “Oligodendroglioma – Neurosurgery | UCLA Health” for neurosurgery; Cancer Research UK’s “Oligodendroglioma” for subtypes; and OncoDaily’s “Oligodendroglioma: Latest Research and Treatments” for 2025 updates.
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