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Pisotriquetral Cyst
Joseph Junewick, MD FACR
over 6 years ago
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Oligoastrocytoma

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 7 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

Teenager with new onset seizures.


Case Images


Diagnosis

Oligoastrocytoma

Findings

MR – Axial images show a left frontal mass which is hypointense on T1 and hyperintense on T2 and T2-FLAIR with pathcy areas of enhancement.

Discussion

Oligoastrocytomas are part of the glial cell continuum that includes both astrocytic and oligodendrocytic components. These tumors are graded based upon the degree of cellularity, cellular pleomorphism, nuclear atypia, and mitotic activity. These tumors typically occur in young adults (mean age at diagnosis, 35–45 years) and manifest with partial or generalized seizures or less commonly headache although some may have no symptoms at all. Most oligoastrocytomas occur in the frontal or temporal lobes. Favorable prognostic factors include young age at presentation (<40 years), lower grade of tumor, and better extent of resection.

On CT scans, oligoastrocytomas typically appear as intraaxial low-attenuation regions with little to no associated edema. Because of their slow growth, the associated mass effect of these tumors tends to be less severe compared with that of similar high-grade lesions. On MR, lesions are usually hypointense on T1 and hyperintense on T2 images. Contrast enhancement is present in approximately half.

A median survival time of 6.3 years as well as 5- and 10-year survival rates of 58% and 32%, respectively, have been reported. Oligodendrogliomas tend to be chemosensitive and astrocytomas are not. Oligoastrocytomas do not respond favorably to chemotherapy, likely because of the astrocytic component. Loss of chromosome 1p and 19q is a characteristic genetic signature which helps to identify the oligodendroglial component.

Reference

Naugle DK, Duncan TD, Grice GP. Oligoastrocytoma. Radiographics (2004); 24:598-600.



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