Oligodendroglioma

An oligodendroglioma is a brain tumor that forms from the so-called oligodendrocytes, mainly in the cerebrum. Oligodendrocytes produce the fatty covering of nerve cells. The average age at diagnosis of an oligodendroglioma is 35 years.

Oligodendroglioma

What is an oligodendroglioma?

Tumors affecting the central nervous system (CNS) are relatively rare. An oligodendroglioma is diagnosed in about 5 percent of these diseases. This type of brain tumor occurs more frequently in adults (9.4% of all primary brain tumors) than in children (4%). See acronymmonster for Definition of Klippel-Feil Syndrome in English.

An oligodendroglioma forms in particular in the frontal or temporal lobes, i.e. the frontal lobes, parietal lobes and occipital lobes. Based on the observation of the tumor under the microscope, the disease is divided into two types: a well-differentiated, slow-growing (class II) oligodendroglioma and an anaplastic, faster-growing oligodendroglioma (class III).

An oligodendroglioma in the frontal lobe of the brain can cause gradual changes in mood and personality, as well as hemiparesis. Problems with coordination and language or memory can be due to an oligodendroglioma in the temporal lobes of the brain.

Causes

As with most brain tumors, the cause of an oligodendroglioma is largely unknown. The central nervous system (CNS) consists of the brain and spinal cord. Cells in the CNS normally grow in an orderly, controlled fashion.

If for any reason this order is disturbed, the cells begin to divide and form a lump or tumor. In the brain there are nerve cells and cells that serve to protect nerve cells. These supporting cells are called glial cells. A tumor that develops there is called a glioma.

Like other tumors, an oligodendroglioma is either benign or malignant. Benign tumors can continue to grow without interfering with normal cell growth. A malignant oligodendroglioma will invade cells, destroy surrounding tissue and spread to other areas of the brain.

Symptoms, Ailments & Signs

The symptoms of an oligodendroglioma are mainly characterized by displacement and compression processes in neighboring brain structures due to tumor growth. Typically, there are general signs of intracranial pressure and focal deficits. Symptoms of intracranial pressure include nausea, vomiting, loss of appetite, tiredness, headaches, disturbances in attention or restlessness.

In severe cases, the symptom triad of high blood pressure, reduced heart rate and shortness of breath is observed. The occurrence of epileptic seizures or strokes is also very typical of an oligodendroglioma. The strokes are due to the fact that the tumors tend to bleed. Edema (perifocal edema) can form around the tumor, which in turn leads to additional masses.

Under certain circumstances, the liquor drain may also be relocated. The resulting accumulation of cerebral fluid also leads to displacement of brain tissue. This can worsen the signs of intracranial pressure, headaches, vomiting and seizures. Without treatment, the development of a life-threatening entrapment of the brainstem is possible. However, not everyone affected develops the same symptoms.

The symptoms depend on which areas of the brain are affected and how the tumor behaves. The speed of growth, the infiltration capacity and the risk of metastasis formation can differ in the various tumors. While in many tumors the symptoms caused by compression processes are in the foreground and are crucial for survival, other symptoms can predominate in the case of early metastasis formation.

Diagnosis & History

People affected by a slow-growing oligodendroglioma can develop mild symptoms for several years before the tumor is discovered. Initial symptoms of any type of brain tumor usually develop due to increased pressure inside the skull (elevated intracranial pressure) that can be caused by the oligodendroglioma.

This leads to headaches, nausea (vomiting) and blurred vision. As the disease progresses, seizures can occur, and in up to 80% of cases personality changes can occur. The diagnosis aims to obtain the most comprehensive information possible about the oligodendroglioma.

Simple reflex tests and an anophthalmoscopy (examination of the back of the eye) initiate further examinations using computed tomography or magnetic resonance imaging. An oligodendroglioma can only be unequivocally diagnosed by a histopathological examination (biopsy).

Complications

Because oligodendroglioma is a tumor in the brain, it comes with the usual symptoms and complications of cancer. The further course of the disease depends very much on the time of diagnosis. In most cases, those affected suffer from severe headaches and also from epileptic seizures. Visual disturbances or nausea can also occur and are often associated with vomiting.

Due to the oligodendroglioma, those affected also suffer from disorders of consciousness and in many cases also from personality changes. Furthermore, there is forgetfulness and general memory disorders. Most patients feel uncomfortable in everyday life and suffer from a general feeling of illness. The quality of life of those affected is significantly restricted and also reduced by the oligodendroglioma.

In many cases, depression or other mental upsets also occur. With the help of surgical interventions and other methods, an oligodendroglioma can be partially treated. However, complete healing does not occur, so that in most cases those affected also have a significantly reduced life expectancy.

When should you go to the doctor?

As a brain tumor, the oligodendroglioma belongs in medical diagnostics and therapy. There are a number of reasons that necessitate a visit to the doctor in this context. This includes the suspicion of a brain tumor as well as side effects of therapies or the consistent adherence to follow-up appointments.

Suspicion of brain tumor activity can arise from sensory disturbances, paralysis or headaches. However, these symptoms are so unspecific that they cannot be clearly assigned to a brain tumor such as oligodendroglioma, but can have a number of other reasons. The first point of contact in this context is therefore the general practitioner. If necessary, he will refer you to physicians from other disciplines such as radiologists or neurologists.

During the therapy of an oligodendroglioma or afterwards, side effects can occur that require a visit to the doctor. Surgery, chemotherapy and radiotherapy put a strain on the body and complications such as postoperative bleeding can be ruled out, as can changes in the blood count, which can lead to serious consequences. The psyche is also a reason for visiting the doctor if a patient cannot cope with the stressful diagnosis. A referral to a psychologist or psycho-oncologist can be useful here.

Follow-up care is also important and linked to appropriate appointments with the doctor. Here it is important not only to follow up on the follow-up appointments consistently, but also to always consult the doctor if unusual, severe or long-lasting symptoms occur.

Treatment & Therapy

According to current medical knowledge, an oligodendroglioma is considered incurable. Studies have shown that with aggressive treatment and close monitoring, it is possible to increase life expectancy. How an oligodendroglioma is treated depends on general health, the anatomy of the tumor, and the spread of the cancer cells.

Treatment is usually carried out by a multidisciplinary team of specialists. Before an oligodendroglioma is treated surgically, drug measures to reduce the pressure in the skull are often initiated. The goal of surgery is to remove the tumor without damaging the surrounding brain tissue.

Because of its diffusely infiltrating nature, an oligodendroglioma cannot be completely eliminated and is not curable by surgery alone. Therefore, other treatment methods are used. Radiation therapy uses high-energy rays to destroy cancer cells. It is usually an external treatment method, but a small radioactive implant can also be used under certain circumstances.

An oligodendroglioma can also be treated with chemotherapy, ie the use of cytotoxic drugs, in addition to surgery or radiation.

Outlook & Forecast

Compared to other brain tumors, the prognosis for oligodendroglioma is better. Some oligodendrogliomas grow slowly. Therefore, the prognosis is significantly better than that of fast-growing and malignant oligodendrogliomas.

The prognosis depends, among other things, on the nature of the tumor cells. If there is a well-differentiated, low-grade oligodendroglioma, the outlook is significantly better than if there is an anaplastic and higher-grade oligodendroglioma with severely degenerated cells.

There is no cure for an oligodendroglioma. The prognosis is about estimating the survival time. With the help of appropriate therapeutic measures, patients can survive a slow-growing oligodendroglioma for ten years or more. In the case of a higher-grade, anaplastic oligodendroglioma, it is only a few months. These prognoses should be viewed with caution because other parameters influence survival.

This includes general health, age, the exact location of the tumor or its size. The therapy and how it works also influences the prognosis. Metastases can form postoperatively or in the case of higher-grade oligodendrogliomas.

On average, cancer specialists expect a survival time of five years for 74 percent of those affected with low-grade oligodendrogliomas. 46 percent of those affected survive longer. Survival rates are significantly lower in highly malignant oligodendrogliomas.

Prevention

Since the causes of brain tumors such as oligodendroglioma are largely unknown, no preventive measures can be taken. Even with an oligodendroglioma, dealing with cancer affects the entire personal environment of the patient and often requires a significant change in lifestyle.

Aftercare

The oligodendroglioma is a brain tumor that requires consistent follow-up care after therapy. This also depends on where the tumor was located and what size it was, whether it had caused any signs of failure and how it was treated. What all tumors have in common, however, is that the patient needs close monitoring so that any renewed tumor growth can be recognized early and treated adequately.

The physical aftercare focuses on the one hand on regeneration after a strenuous treatment phase and on the other hand on symptoms of failure or other problems as a result of the tumor. The person affected often learns individually suitable exercises in the context of speech therapy, ergotherapy or physiotherapy, which can then be consistently practiced at home. The consequences of radiotherapy and chemotherapy can often be easily managed through a healthy lifestyle. Excessive alcohol consumption and especially nicotine should be avoided here.

Psychological follow-up care is also important in order to be able to process the diagnosis of a brain tumor and the fear of a relapse. Talking to family and friends can be helpful in this regard, as can attending an oncology support group. Relaxation techniques can also be helpful. The progressive muscle relaxation according to Jacobsen is also a gentle motor training. Yoga also calms through the combination of physical, breathing and relaxation exercises.

You can do that yourself

As a brain tumor, oligodendroglioma should always be treated by a specialist, but there are also a few things that the patient can do to help themselves in everyday life. This everyday help can be divided into the physical and the mental-spiritual area.

In the physical area, motor skills are often limited by the tumor itself or an operation. Physiotherapists or ergotherapists often teach exercises that the patient can carry out on their own at home. In addition to exercises for these local limitations, there are also opportunities to improve the patient’s overall condition, especially after radiation or chemotherapy. This includes a healthy diet and a sufficient amount of fluids as well as dosed exercise, which is possible either at home or in a sports club, but also in special rehabilitation courses. Shortening and tension in the muscles can be relaxed with the help of massages.

The mental and emotional state can also be positively influenced by self-help. On the one hand, this applies to cognitive abilities: Like language, perception and memory can be trained with suitable exercises. In the mental area, those affected often find it difficult to think about the brain tumor. Discussions with relatives, friends or in self-groups can help here. Methods such as progressive muscle relaxation according to Jacobsen, autogenic training or yoga ensure relaxation.