Oligoastrocytoma overview: Difference between revisions
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==History and Symptoms== | ==History and Symptoms== | ||
When evaluating a patient for oligoastrocytoma, you should take a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, and a thorough past medical history review. Other specific areas of focus when obtaining the history include review of the history of any ionizing [[radiation]], [[Allergy|allergic diseases]] | When evaluating a patient for oligoastrocytoma, you should take a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, and a thorough past medical history review. Other specific areas of focus when obtaining the history include review of the history of any ionizing [[radiation]], [[Allergy|allergic diseases]], and the [[family history]] for any [[brain tumors]].<ref name="pmid21149253">{{cite journal| author=McCarthy BJ, Rankin KM, Aldape K, Bondy ML, Brännström T, Broholm H et al.| title=Risk factors for oligodendroglial tumors: a pooled international study. | journal=Neuro Oncol | year= 2011 | volume= 13 | issue= 2 | pages= 242-50 | pmid=21149253 | doi=10.1093/neuonc/noq173 | pmc=PMC3064625 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21149253 }} </ref><ref name="pmid19216998">{{cite journal| author=Terry MB, Howe G, Pogoda JM, Zhang FF, Ahlbom A, Choi W et al.| title=An international case-control study of adult diet and brain tumor risk: a histology-specific analysis by food group. | journal=Ann Epidemiol | year= 2009 | volume= 19 | issue= 3 | pages= 161-71 | pmid=19216998 | doi=10.1016/j.annepidem.2008.12.010 | pmc=PMC3832293 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19216998 }} </ref><ref name="pmid18533376">{{cite journal| author=Chandana SR, Movva S, Arora M, Singh T| title=Primary brain tumors in adults. | journal=Am Fam Physician | year= 2008 | volume= 77 | issue= 10 | pages= 1423-30 | pmid=18533376 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18533376 }} </ref> Symptoms associated with oligoastrocytoma include [[seizure]], [[headache]], [[nausea]], [[vomiting]], [[Ataxia|loss of balance]], [[vision loss]], and changes in [[Dysarthria|speech]], [[mood disorders|mood]], and [[personality pathology|personality]].<ref name=symptomwiki>Symptoms of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015</ref><ref name="pmid15026604">{{cite journal| author=Naugle DK, Duncan TD, Grice GP| title=Oligoastrocytoma. | journal=Radiographics | year= 2004 | volume= 24 | issue= 2 | pages= 598-600 | pmid=15026604 | doi=10.1148/rg.242035069 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15026604 }} </ref><ref name=wikiOA1>Symptoms of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015</ref><ref name="pmid20425038">{{cite journal| author=Pouratian N, Schiff D| title=Management of low-grade glioma. | journal=Curr Neurol Neurosci Rep | year= 2010 | volume= 10 | issue= 3 | pages= 224-31 | pmid=20425038 | doi=10.1007/s11910-010-0105-7 | pmc=PMC2857752 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20425038 }} </ref><ref name=wikiglioss1>Signs and symptoms of glioma. Wikipedia 2015. https://en.wikipedia.org/wiki/Glioma. Accessed on October 20, 2015</ref><ref name=OAsymp2>Symptoms of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015</ref><ref name="pmid18533376">{{cite journal| author=Chandana SR, Movva S, Arora M, Singh T| title=Primary brain tumors in adults. | journal=Am Fam Physician | year= 2008 | volume= 77 | issue= 10 | pages= 1423-30 | pmid=18533376 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18533376 }} </ref> | ||
==Physical examination== | ==Physical examination== | ||
Revision as of 16:53, 2 November 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
Oligoastrocytomas are mixed tumors that arises from the proliferation of both oligodendrocytes and astrocytes.[1] Celli et al in 1994 gave the name of "oligoastrocytoma" to those oligodendroglial tumors where the astrocytes formed more than 20% of the tumor cells.[2] Oligoastrocytoma may be classified according to the WHO classification of the central nervous system tumors into two subtypes: oligoastrocytoma (OAII) and anaplastic oligoastrocytoma (OAIII).[3] Genes associated with the pathogenesis of oligoastrocytoma and anaplastic oligoastrocytoma include IDH1, p53, EGFR, ATRX, EGFR, PTEN, MGMT, CIC, and FUBP1.[4][5][6][7][8][9][10][11] 30-70% of oligoastrocytomas show loss of heterozygosity (LOH) of 1p and 19q.[4][11][12] On gross pathology, oligoastrocytoma is characterized by soft, well-defined, grey-tan, mucoid or hemorrhagic, calcified mass with or without necrosis, which may expand the gyrus and cause blurring of the grey-white matter junction.[11] On microscopic histopathological analysis, oligoastrocytoma is characterized by highly cellular lesions composed of both oligodendroglial and astrocytic components.[13][14][15][16][17] In addition to the histological features of oligoastrocytoma, anaplastic oligoastrocytoma also has significant or brisk mitotic activity, marked cytologic and nuclear atypia, necrosis, apoptosis, and microvacular proliferation.[13][14][15] Oligoastrocytoma is demonstrated by positivity to tumor markers such as MAP2, GFAP, IDH1, OLIG-1 protein, OLIG-2 protein, and Iba-2 protein.[18][19][10][20][11] Oligoastrocytoma must be differentiated from astrocytoma, anaplastic astrocytoma, oligodendroglioma, pilocytic astrocytoma, central neurocytoma, ependymoma, dysembryoplastic neuroepithelial tumor, meningioma, and cerebral metastasis.[21][11][22][23] Oligoastrocytoma is the third most common glioma.[24] Oligoastrocytoma accounts for 1% of all brain tumors and 5–10% of all glial neoplasms.[25] The incidence of oligoastrocytoma is approximately 0.03 per 100,000 individuals in the United States.[26] Oligoastrocytoma is a disease that tends to affect the young and middle-aged adult population.[25] The median age of diagnosis is 42 years.[27] If left untreated, patients with oligoastrocytoma may progress to develop seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.[23][20][28] Common complications associated with oligoastrocytoma include hydrocephalus, intracranial hemorrhage, coma, metastasis, venous thromboembolism, and side effects of chemotherapy and radiation.[20][29][30][23][31][28] Depending on the extent and grade of the tumor at the time of diagnosis, the prognosis of oligoastrocytoma may vary. However, the prognosis is generally regarded as good.[10] Symptoms associated with oligoastrocytoma include seizure, headache, nausea, vomiting, loss of balance, vision loss, and changes in speech, mood, and personality.[32][14][33][22][30][34][23] Head CT scan and brain MRI are helpful in the diagnosis of oligoastrocytoma. Findings on CT scan suggestive of oligoastrocytoma are intra-axial low-attenuation areas with mass effect and little to no associated edema.[35] On brain MRI, oligoastrocytoma is characterized by a mass which is typically hypointense on T1-weighted images and hyperintense on T2-weighted images. No enhancement is observed on gadolinium enhanced T1-weighted images.[36] Other imaging studies for oligoastrocytoma include PET scan (accumulation of [18F]-fluorodeoxyglucose) and bone scan (bone metastasis).[37][38][39][31] The predominant therapy for oligoastrocytoma is surgical resection.[22][23] Adjunctive chemotherapy and radiation are required.[22][23][40][41][42][4][29] Supportive therapy for oligoastrocytoma includes anticonvulsants and corticosteroids.[40] Patients treated for oligoastrocytoma should follow-up for secondary prevention. Secondary prevention strategies following oligoastrocytoma include a clinical assessment of neurological function and corticosteroid usage, checking for signs of venous thromboembolism, regular laboratory tests, and routine imaging (MRI and Positron Emission Tomography) at scheduled intervals after treatment.[29]
Historical Perspective
The broad topic "oligodendroglial tumors", of which oligoastrocytoma is a part of, was first described by Bailey and Cushing in 1926. They reported that gliomas were formed by transformation of glial cells.[43][44] Celli et al in 1994 gave the name of "oligoastrocytoma" to those oligodendroglial tumors where the astrocytes formed more than 20% of the tumor cells.[2]
Classification
Oligoastrocytoma may be classified according to the WHO classification of the central nervous system tumors into two subtypes: oligoastrocytoma (OAII) and anaplastic oligoastrocytoma (OAIII).[3]
Pathophysiology
Oligoastrocytomas are mixed tumors that arise from the proliferation of both oligodendrocytes and astrocytes.[1] Genes associated with the pathogenesis of oligoastrocytoma and anaplastic oligoastrocytoma include IDH1, p53, EGFR, ATRX, EGFR, PTEN, MGMT, CIC, and FUBP1.[4][5][6][7][8][9][10][11] 30-70% of oligoastrocytomas show loss of heterozygosity (LOH) of 1p and 19q.[4][11][12] On gross pathology, oligoastrocytoma is characterized by a soft, well-defined, grey-tan, mucoid or hemorrhagic, calcified mass with or without necrosis, which may expand the gyrus and cause blurring of the grey-white junction.[11] On microscopic histopathological analysis, oligoastrocytoma is characterized by highly cellular lesions composed of both oligodendroglial and astrocytic components.[13][14][15][16][17] In addition to the histological features of oligoastrocytoma, anaplastic oligoastrocytoma also has significant or brisk mitotic activity, marked cytologic and nuclear atypia, necrosis, apoptosis, and microvacular proliferation.[13][14][15] Oligoastrocytoma is demonstrated by positivity to tumor markers such as MAP2, GFAP, IDH1, OLIG-1 protein, OLIG-2 protein, and Iba-2 protein.[18][19][10][20][11]
Causes
Common causes of oligoastrocytoma include genetic mutations. Common genetic mutations involved in the development of oligoastrocytoma can be found here.[4][5][6][7][8][9]
Differentiating Oligodendroglioma from other diseases
Oligoastrocytoma must be differentiated from astrocytoma, anaplastic astrocytoma, oligodendroglioma, pilocytic astrocytoma, central neurocytoma, ependymoma, dysembryoplastic neuroepithelial tumor, meningioma, and cerebral metastasis.[21][11][22][23]
Epidemiology and Demographics
Oligoastrocytoma is the third most common glioma.[24] Oligoastrocytoma accounts for 1% of all brain tumors and 5–10% of all glial neoplasms.[25] The incidence of oligoastrocytoma is approximately 0.03 per 100,000 individuals in the United States.[26] Oligoastrocytoma is a disease that tends to affect the young and middle-aged adult population.[25] The median age of diagnosis is 42 years.[27] Males are more commonly affected with oligoastrocytoma than females.[45] Oligoastrocytoma usually affects individuals of the Caucasian race.[46] The incidence rate of oligoastrocytoma is higher in developed countries than in developing countries.[47]
Risk factors
Common risk factors in the development of oligoastrocytoma include family history of brain tumors, ionizing radiation, and allergic diseases.[48]
Screening
There is insufficient evidence to recommend routine screening for oligoastrocytoma.[49]
Natural History, Complications and Prognosis
If left untreated, patients with oligoastrocytoma may progress to develop seizures, focal neurological deficits, hydrocephalus, brain herniation, intracranial hemorrhage, and ultimately death.[23][20][28] Oligoastrocytomas are slow growing tumors.[11] Common complications associated with oligoastrocytoma include hydrocephalus, intracranial hemorrhage, coma, metastasis, venous thromboembolism, and side effects of chemotherapy and radiation.[20][29][30][23][31][28] Depending on the extent and grade of the tumor at the time of diagnosis, the prognosis of oligoastrocytoma may vary. However, the prognosis is generally regarded as good.[10] The prognosis of low-grade oligoastrocytoma is more favorable than that for anaplastic oligoastrocytoma because of the more indolent course and younger age at which most patients are diagnosed.[20] The 1, 5, and 10-year survival rates of patients with oligoastrocytoma are approximately 87%, 56.97%, and 45.80%, respectively.[50]
Diagnosis
Staging
There is no established system for the staging of oligoastrocytoma.[23]
History and Symptoms
When evaluating a patient for oligoastrocytoma, you should take a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, and a thorough past medical history review. Other specific areas of focus when obtaining the history include review of the history of any ionizing radiation, allergic diseases, and the family history for any brain tumors.[48][51][23] Symptoms associated with oligoastrocytoma include seizure, headache, nausea, vomiting, loss of balance, vision loss, and changes in speech, mood, and personality.[32][14][33][22][30][34][23]
Physical examination
Common physical examination findings of oligoastrocytoma include nystagmus, papilledema, esotropia, visual field loss, altered mental status, and focal neurological deficits.[22][23]
Laboratory Findings
Some patients with oligoastrocytoma may have elevated protein and cell count with normal glucose and lactate on CSF analysis, which is usually suggestive of hydrocephalus.[52][53]
Chest X Ray
Chest x-ray may be performed to detect metastases of anaplastic oligoastrocytoma to the lungs.[54][31]
CT
Head CT scan may be helpful in the diagnosis of oligoastrocytoma. Findings on CT scan suggestive of oligoastrocytoma are intra-axial low-attenuation areas with mass effect and little to no associated edema.[35]
MRI
Brain MRI is helpful in the diagnosis of oligoastrocytoma. On brain MRI, oligoastrocytoma is characterized by a mass which is typically hypointense on T1-weighted images and hyperintense on T2-weighted images. No enhancement is observed on gadolinium enhanced T1-weighted images.[36]
Ultrasound
There are no ultrasound findings associated with oligoastrocytoma.
Other Imaging Findings
Other imaging studies for oligoastrocytoma include PET scan (accumulation of [18F]-fluorodeoxyglucose) and bone scan (bone metastasis).[37][38][39][31]
Other Diagnostic Studies
Other diagnostic studies for oligoastrocytoma include biopsy ("star-shaped" astrocytes with ovoid nucleus and homogeneous, compact oligodendrocytes with distinct borders, round nucleus, and clear cytoplasm surrounding a dense central nucleus and perinuclear halo, giving it the characteristic “fried egg” appearance) and fluorescent in-situ hybridization (FISH) technique (deletions of chromosome 1p and 19q).[55][56]
Treatment
Medical Therapy
The predominant therapy for oligoastrocytoma is surgical resection.[22][23] Adjunctive chemotherapy and radiation are required.[22][23][40][41][42][4][29] Supportive therapy for oligoastrocytoma includes anticonvulsants and corticosteroids.[40]
Surgery
Surgery is the first-line treatment option for patients with oligoastrocytoma.[22][23][40][57] CSF shunting is usually reserved for patients with hydrocephalus.[53]
Primary Prevention
There are no primary preventive measures available for oligoastrocytoma.
Secondary Prevention
Patients treated for oligoastrocytoma should follow-up for secondary prevention. Secondary prevention strategies following oligoastrocytoma include a clinical assessment of neurological function and corticosteroid usage, checking for signs of venous thromboembolism, regular laboratory tests, and routine imaging (MRI and Positron Emission Tomography) at scheduled intervals after treatment.[29]
References
- ↑ 1.0 1.1 Introduction of oligodendroglioma and oligoastrocytoma. American Brain Tumor Association. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 16, 2015
- ↑ 2.0 2.1 Celli P, Nofrone I, Palma L, Cantore G, Fortuna A (1994). "Cerebral oligodendroglioma: prognostic factors and life history". Neurosurgery. 35 (6): 1018–34, discussion 1034-5. PMID 7885546.
- ↑ 3.0 3.1 Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A; et al. (2007). "The 2007 WHO classification of tumours of the central nervous system". Acta Neuropathol. 114 (2): 97–109. doi:10.1007/s00401-007-0243-4. PMC 1929165. PMID 17618441.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J; et al. (2002). "Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets". Am J Pathol. 161 (1): 313–9. doi:10.1016/S0002-9440(10)64183-1. PMC 1850690. PMID 12107116.
- ↑ 5.0 5.1 5.2 Sahm F, Reuss D, Koelsche C, Capper D, Schittenhelm J, Heim S; et al. (2014). "Farewell to oligoastrocytoma: in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma". Acta Neuropathol. 128 (4): 551–9. doi:10.1007/s00401-014-1326-7. PMID 25143301.
- ↑ 6.0 6.1 6.2 Viana-Pereira M, Lopes JM, Little S, Milanezi F, Basto D, Pardal F; et al. (2008). "Analysis of EGFR overexpression, EGFR gene amplification and the EGFRvIII mutation in Portuguese high-grade gliomas". Anticancer Res. 28 (2A): 913–20. PMID 18507036.
- ↑ 7.0 7.1 7.2 Ermoian RP, Furniss CS, Lamborn KR, Basila D, Berger MS, Gottschalk AR; et al. (2002). "Dysregulation of PTEN and protein kinase B is associated with glioma histology and patient survival". Clin Cancer Res. 8 (5): 1100–6. PMID 12006525.
- ↑ 8.0 8.1 8.2 van den Bent MJ, Erdem-Eraslan L, Idbaih A, de Rooi J, Eilers PH, Spliet WG; et al. (2013). "MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic Oligodendrogliomas and Oligoastrocytomas. A report from EORTC study 26951". Clin Cancer Res. 19 (19): 5513–22. doi:10.1158/1078-0432.CCR-13-1157. PMID 23948976.
- ↑ 9.0 9.1 9.2 Jiao Y, Killela PJ, Reitman ZJ, Rasheed AB, Heaphy CM, de Wilde RF; et al. (2012). "Frequent ATRX, CIC, FUBP1 and IDH1 mutations refine the classification of malignant gliomas". Oncotarget. 3 (7): 709–22. PMC 3443254. PMID 22869205.
- ↑ 10.0 10.1 10.2 10.3 10.4 10.5 Liang Y, Bollen AW, Nicholas MK, Gupta N (2005). "Id4 and FABP7 are preferentially expressed in cells with astrocytic features in oligodendrogliomas and oligoastrocytomas". BMC Clin Pathol. 5: 6. doi:10.1186/1472-6890-5-6. PMC 1182359. PMID 16018821.
- ↑ 11.00 11.01 11.02 11.03 11.04 11.05 11.06 11.07 11.08 11.09 11.10 Adesina, Adekunle (2010). Atlas of pediatric brain tumors. New York: Springer. ISBN 9781441910622.
- ↑ 12.0 12.1 Cause of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015
- ↑ 13.0 13.1 13.2 13.3 Pathology of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 16, 2015
- ↑ 14.0 14.1 14.2 14.3 14.4 14.5 Naugle DK, Duncan TD, Grice GP (2004). "Oligoastrocytoma". Radiographics. 24 (2): 598–600. doi:10.1148/rg.242035069. PMID 15026604.
- ↑ 15.0 15.1 15.2 15.3 Pathology of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015
- ↑ 16.0 16.1 Love, S.; Loius, D. & Ellison, D.W. (2008), Greenfield's neuropathology, 1 (8th ed.), Boca Raton, Florida: Hodder Arnold
- ↑ 17.0 17.1 Histology of anaplastic oligoastrocytes. Dr. Frank Gaillard. Radiopaedia 2015. http://radiopaedia.org/cases/anaplastic-oligoastrocytoma. Accessed on October 19, 2015
- ↑ 18.0 18.1 IHC of oligoastrocytoma. Librepathology 2015. http://librepathology.org/wiki/index.php/Oligoastrocytoma. Accessed on October 16, 2015
- ↑ 19.0 19.1 Kolenda-Roberts HM, Harris N, Singletary E, Hardisty JF (2013). "Immunohistochemical characterization of spontaneous and acrylonitrile-induced brain tumors in the rat". Toxicol Pathol. 41 (1): 98–108. doi:10.1177/0192623312452492. PMID 22821367.
- ↑ 20.0 20.1 20.2 20.3 20.4 20.5 20.6 Grier, J. T. (2006). "Low-Grade Gliomas in Adults". The Oncologist. 11 (6): 681–693. doi:10.1634/theoncologist.11-6-681. ISSN 1083-7159.
- ↑ 21.0 21.1 DDx of oligoastrocytoma. Librepathology 2015. http://librepathology.org/wiki/index.php/Oligoastrocytoma. Accessed on October 16, 2015
- ↑ 22.0 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 Pouratian N, Schiff D (2010). "Management of low-grade glioma". Curr Neurol Neurosci Rep. 10 (3): 224–31. doi:10.1007/s11910-010-0105-7. PMC 2857752. PMID 20425038.
- ↑ 23.00 23.01 23.02 23.03 23.04 23.05 23.06 23.07 23.08 23.09 23.10 23.11 23.12 23.13 23.14 23.15 Chandana SR, Movva S, Arora M, Singh T (2008). "Primary brain tumors in adults". Am Fam Physician. 77 (10): 1423–30. PMID 18533376.
- ↑ 24.0 24.1 Epidemiology of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 16, 2015
- ↑ 25.0 25.1 25.2 25.3 Incidence of oligoastrocytomas. American Brain Tumor Association. http://www.abta.org/brain-tumor-information/types-of-tumors/oligoastrocytoma.html?referrer=https://www.google.com/. Accessed on October 16, 2015
- ↑ 26.0 26.1 Selected Childhood Primary (Malignant and Non-Mailgnant) Brain and Central Nervous System Tumor, Age–specific and Age–adjusted Incidence rates by Major Histology Groupings, Histology and Age at diagnosis; CBTRUS Statistical Report: NPCR and SEER, 2004-2006. CBTRUS 2015. http://www.cbtrus.org/2010-NPCR-SEER/CBTRUS-WEBREPORT-Final-3-2-10.pdf. Accessed on October 16, 2015
- ↑ 27.0 27.1 Oligoastrocytomas. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015
- ↑ 28.0 28.1 28.2 28.3 Specht CS, Pinto-Lord C, Smith TW, DeGirolami U, Suran E, Marshall PC; et al. (1986). "Spontaneous hemorrhage in a mixed glioma of the cerebellum: case report". Neurosurgery. 19 (2): 278–81. PMID 3748360.
- ↑ 29.0 29.1 29.2 29.3 29.4 29.5 Stupp R, Tonn JC, Brada M, Pentheroudakis G, ESMO Guidelines Working Group (2010). "High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up". Ann Oncol. 21 Suppl 5: v190–3. doi:10.1093/annonc/mdq187. PMID 20555079.
- ↑ 30.0 30.1 30.2 30.3 Signs and symptoms of glioma. Wikipedia 2015. https://en.wikipedia.org/wiki/Glioma. Accessed on October 20, 2015
- ↑ 31.0 31.1 31.2 31.3 31.4 Finsterer J, Breiteneder S, Mueller MR, Wogritsch C, Vesely M, Kleinert R; et al. (1998). "Pleural and bone marrow metastasis from supratentorial oligoastrocytoma grade III". Oncology. 55 (4): 345–8. PMID 9663425.
- ↑ 32.0 32.1 Symptoms of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015
- ↑ 33.0 33.1 Symptoms of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015
- ↑ 34.0 34.1 Symptoms of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015
- ↑ 35.0 35.1 Radiologic features of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 18, 2015
- ↑ 36.0 36.1 Radiologic MRI features of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma
- ↑ 37.0 37.1 la Fougere, C.; Suchorska, B.; Bartenstein, P.; Kreth, F.-W.; Tonn, J.-C. (2011). "Molecular imaging of gliomas with PET: Opportunities and limitations". Neuro-Oncology. 13 (8): 806–819. doi:10.1093/neuonc/nor054. ISSN 1522-8517.
- ↑ 38.0 38.1 Beauchesne P (2011). "Extra-neural metastases of malignant gliomas: myth or reality?". Cancers (Basel). 3 (1): 461–77. doi:10.3390/cancers3010461. PMC 3756372. PMID 24212625.
- ↑ 39.0 39.1 Al-Ali F, Hendon AJ, Liepman MK, Wisniewski JL, Krinock MJ, Beckman K (2005). "Oligodendroglioma metastatic to bone marrow". AJNR Am J Neuroradiol. 26 (9): 2410–4. PMID 16219856.
- ↑ 40.0 40.1 40.2 40.3 40.4 Treatment of mixed gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on. Accessed on October 20, 2015
- ↑ 41.0 41.1 Chemotherapeutic drugs in malignant gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/treatment/chemotherapy/?region=on. Accessed on October 20, 2015
- ↑ 42.0 42.1 Hoang-Xuan K, Capelle L, Kujas M, Taillibert S, Duffau H, Lejeune J; et al. (2004). "Temozolomide as initial treatment for adults with low-grade oligodendrogliomas or oligoastrocytomas and correlation with chromosome 1p deletions". J Clin Oncol. 22 (15): 3133–8. doi:10.1200/JCO.2004.10.169. PMID 15284265.
- ↑ "A classification of the tumours of the glioma group on a histogenetic basis, with a correlated study of prognosis. By Percival Bailey and Harvey Cushing. Medium 8vo. Pp. 175, with 108 illustrations. 1926. Philadelphia, London, and Montreal: J. B. Lippincott Company. 21s. net". British Journal of Surgery. 14 (55): 554–555. 1927. doi:10.1002/bjs.1800145540. ISSN 0007-1323.
- ↑ Chowdhary S, Chamberlain MC (2006). "Oligodendroglial tumors". Expert Rev Neurother. 6 (4): 519–32. doi:10.1586/14737175.6.4.519. PMID 16623651.
- ↑ Patterns by Gender for Selected Histologies CBTRUS Statistical Report: NPCR and SEER Data from 2004-2006. CBTRUS 2015. http://www.cbtrus.org/2010-NPCR-SEER/CBTRUS-WEBREPORT-Final-3-2-10.pdf. Accessed on October 16, 2015
- ↑ Patterns by Race for Selected Histologies. CBTRUS 2015. http://www.cbtrus.org/2010-NPCR-SEER/CBTRUS-WEBREPORT-Final-3-2-10.pdf. Accessed on October 16, 2015
- ↑ Ohgaki H, Kleihues P (2005). "Epidemiology and etiology of gliomas". Acta Neuropathol. 109 (1): 93–108. doi:10.1007/s00401-005-0991-y. PMID 15685439.
- ↑ 48.0 48.1 McCarthy BJ, Rankin KM, Aldape K, Bondy ML, Brännström T, Broholm H; et al. (2011). "Risk factors for oligodendroglial tumors: a pooled international study". Neuro Oncol. 13 (2): 242–50. doi:10.1093/neuonc/noq173. PMC 3064625. PMID 21149253.
- ↑ Early detection, diagnosis, and staging of brain tumors. American cancer society. http://www.cancer.org/cancer/braincnstumorsinadults/detailedguide/brain-and-spinal-cord-tumors-in-adults-detection
- ↑ One–, Two–, Three–, Four–, Five–, and 10–year relative survival rates for selected malignant brain and central nervous system tumors, Seer 17 Registries, 1995-2006. CBTRUS 2015. http://www.cbtrus.org/2010-NPCR-SEER/CBTRUS-WEBREPORT-Final-3-2-10.pdf. Accessed on October 16, 2015
- ↑ Terry MB, Howe G, Pogoda JM, Zhang FF, Ahlbom A, Choi W; et al. (2009). "An international case-control study of adult diet and brain tumor risk: a histology-specific analysis by food group". Ann Epidemiol. 19 (3): 161–71. doi:10.1016/j.annepidem.2008.12.010. PMC 3832293. PMID 19216998.
- ↑ Stark AM, Hugo HH, Mehdorn HM, Knerlich-Lukoschus F (2009). "Acute Hydrocephalus due to Secondary Leptomeningeal Dissemination of an Anaplastic Oligodendroglioma". Case Rep Med. 2009: 370901. doi:10.1155/2009/370901. PMC 2797365. PMID 20052406.
- ↑ 53.0 53.1 Li KW, Roonprapunt C, Lawson HC, Abbott IR, Wisoff J, Epstein F; et al. (2005). "Endoscopic third ventriculostomy for hydrocephalus associated with tectal gliomas". Neurosurg Focus. 18 (6A): E2. PMID 16048288.
- ↑ Lone, N. A.; Thameem, D.; Syed, S. J.; Kingree, R. M.; Holly, J. S.; Dhand, R.; Jadhav, A. (2010). "Pulmonary Deposits of Anaplastic Oligoastrocytoma: Can It Be Prevented or Early Detected?". Chest. 138 (4 MeetingAbstracts): 64A–64A. doi:10.1378/chest.10865. ISSN 0012-3692.
- ↑ Diagnosis of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015
- ↑ Ersen, Ayca (2008), Pathology of malignant gliomas: Challenges of everyday practice and the WHO 2007, Turkish Journal of Pathology, retrieved 20 October, 2015 Check date values in:
|accessdate=(help) - ↑ Eskandar EN, Loeffler JS, O'Neill AM, Hunter GJ, Louis DN (2004). "Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 33-2004. A 34-year-old man with a seizure and a frontal-lobe brain lesion". N Engl J Med. 351 (18): 1875–82. doi:10.1056/NEJMcpc049025. PMID 15509821.