Oligoastrocytoma (historical)
Updates to Article Attributes
Oligoastrocytomas(OAs) are
The literature is somewhat conflicted on these entities, with imaging appearance and incidence varying widely. As of the latestupdated 4th edition (2016) update toof the WHO classification of CNS tumours, their incidence will be greatly reduced 8.
Epidemiology
Historically these tumours have in some institutions been encountered commonly, in some instances accounting for 50% of all oligodendrogliomas and considered the third most common glial neoplasm 2. However, it is not possible to infer a reliable incidence of oligoastrocytomas due to the vague criteria for their definition and wide interobserver variability 6.
The peak manifestation is during the 3rd and 4th decades 1.
Clinical presentation
Oligoastrocytomas most commonly present with either partial or generalised seizures 7.
Pathology
Oligoastrocytomas are WHO Grade II and anaplastic oligoastrocytomas are WHO Grade III.
Malignancy histologic features such as high cellularity, pleomorphism, nuclear atypia, and increased mitotic activity are usually found in the anaplastic oligoastrocytomas. Necrosis and microvascular proliferation may also be present but are not required for diagnosis 1.
As of the latestThe updated 4th edition (2016) update to to the WHO classification of CNS tumours, their incidence will be greatly reduced as the diagnosis will require required molecularly distinct populations of both components to be identified: astrocytic (IDH-mutant, ATRX-mutant, 1p19q-intact) and oligodendrogliocytic (IDH-mutant, ATRX-wildtype, 1p19q co-deleted) 8.
In the more recent 5th edition (2021) the term oligoastrocytoma is no longer recognised as a distinct diagnosis 9.
Radiographic features
On imaging, they have appearances that are essentially indistinguishable from their constituent tumours. There arewere no specific features to reliably help separate oligoastrocytomas, astrocytomas and oligodendrogliomas.
CT
Usually presented as an intra-axial low-attenuation area with little to no associated oedema.
MRI
- T1: usually hypointense
- T2: usually hyperintense
- T1 C+ (Gd): usually non-enhancing lesions
Treatment and prognosis
Oligoastroctyomas respondresponded less favourably to chemotherapy due to the chemoresistance of their astrocytic component 4. Studies have shown that the standard of care for oligodendroglial tumours that are 1p19q codeleted should be the combination of chemotherapy and radiation therapy 5.
A favourable prognosis is found in those with young age, WHO III, and better extent of resection 3.
-<p><strong>Oligoastrocytomas</strong> <strong>(OAs)</strong> are intracranial tumours that are part of the glial cell continuum, with mixed oligodendroglial and astrocytic cell populations and typically occur in young adults. </p><p>The literature is somewhat conflicted on these entities, with imaging appearance and incidence varying widely. As of the latest (2016) update to the <a href="/articles/who-classification-of-cns-tumours-1">WHO classification of CNS tumours</a>, their incidence will be greatly reduced <sup>8</sup>. </p><h4>Epidemiology</h4><p>Historically these tumours have in some institutions been encountered commonly, in some instances accounting for 50% of all <a href="/articles/oligodendroglioma">oligodendrogliomas</a> and considered the third most common glial neoplasm<sup> 2</sup>. However, it is not possible to infer a reliable incidence of oligoastrocytomas due to the vague criteria for their definition and wide interobserver variability <sup>6</sup>.</p><p>The peak manifestation is during the 3<sup>rd</sup> and 4<sup>th</sup> decades <sup>1</sup>.</p><h4>Clinical presentation</h4><p>Oligoastrocytomas most commonly present with either partial or generalised seizures <sup>7</sup>.</p><h4>Pathology</h4><p>Oligoastrocytomas are <a href="/articles/who-classification-of-cns-tumours-1">WHO Grade</a> II and anaplastic oligoastrocytomas are WHO Grade III.</p><p>Malignancy histologic features such as high cellularity, pleomorphism, nuclear atypia, and increased mitotic activity are usually found in the anaplastic oligoastrocytomas. Necrosis and microvascular proliferation may also be present but are not required for diagnosis <sup>1</sup>.</p><p>As of the latest (2016) update to the <a href="/articles/who-classification-of-cns-tumours-1">WHO classification of CNS tumours</a>, their incidence will be greatly reduced as the diagnosis will require molecularly distinct populations of both components to be identified: astrocytic (<a href="/articles/isocitrate-dehydrogenase">IDH-mutant</a>, <a href="/articles/alpha-thalassemiaintellectual-disability-syndrome-x-linked-atrx-gene-tumour-marker">ATRX-mutant</a>, 1p19q-intact) and oligodendrogliocytic (IDH-mutant, ATRX-wildtype, <a href="/articles/1p19q-codeletion">1p19q co-deleted</a>) <sup>8</sup>. </p><h4>Radiographic features</h4><p>On imaging, they have appearances that are essentially indistinguishable from their constituent tumours. There are no specific features to help separate oligoastrocytomas, astrocytomas and oligodendrogliomas. </p><h5>CT</h5><p>Usually presented as an intra-axial low-attenuation area with little to no associated oedema.</p><h5>MRI</h5><ul>- +<p><strong>Oligoastrocytomas</strong> is a historical term no longer recognised in the current <a href="/articles/who-classification-of-cns-tumours-1">WHO classification of CNS tumours</a> used to denote intracranial tumours that are part of the glial cell continuum, with mixed oligodendroglial and astrocytic cell populations and typically occur in young adults. </p><p>The literature is somewhat conflicted on these entities, with imaging appearance and incidence varying widely. As of the updated 4th edition (2016) of the <a href="/articles/who-classification-of-cns-tumours-1">WHO classification of CNS tumours</a>, their incidence greatly reduced <sup>8</sup>. </p><h4>Epidemiology</h4><p>Historically these tumours have in some institutions been encountered commonly, in some instances accounting for 50% of all <a href="/articles/oligodendroglioma">oligodendrogliomas</a> and considered the third most common glial neoplasm<sup> 2</sup>. However, it is not possible to infer a reliable incidence of oligoastrocytomas due to the vague criteria for their definition and wide interobserver variability <sup>6</sup>.</p><p>The peak manifestation is during the 3<sup>rd</sup> and 4<sup>th</sup> decades <sup>1</sup>.</p><h4>Clinical presentation</h4><p>Oligoastrocytomas most commonly present with either partial or generalised seizures <sup>7</sup>.</p><h4>Pathology</h4><p>The updated 4th edition (2016) to the <a href="/articles/who-classification-of-cns-tumours-1">WHO classification of CNS tumours</a> required molecularly distinct populations of both components to be identified: astrocytic (<a href="/articles/isocitrate-dehydrogenase">IDH-mutant</a>, <a href="/articles/alpha-thalassemiaintellectual-disability-syndrome-x-linked-atrx-gene-tumour-marker">ATRX-mutant</a>, 1p19q-intact) and oligodendrogliocytic (IDH-mutant, ATRX-wildtype, <a href="/articles/1p19q-codeletion">1p19q co-deleted</a>) <sup>8</sup>. </p><p>In the more recent 5th edition (2021) the term oligoastrocytoma is no longer recognised as a distinct diagnosis <sup>9</sup>. </p><h4>Radiographic features</h4><p>On imaging, they have appearances that are essentially indistinguishable from their constituent tumours. There were no specific features to reliably help separate oligoastrocytomas, astrocytomas and oligodendrogliomas. </p><h5>CT</h5><p>Usually presented as an intra-axial low-attenuation area with little to no associated oedema.</p><h5>MRI</h5><ul>
-</ul><h4>Treatment and prognosis</h4><p>Oligoastroctyomas respond less favourably to chemotherapy due to the chemoresistance of their astrocytic component <sup>4</sup>. Studies have shown that the standard of care for oligodendroglial tumours that are 1p19q codeleted should be the combination of chemotherapy and radiation therapy <sup>5</sup>.</p><p>A favourable prognosis is found in those with young age, WHO III, and better extent of resection <sup>3</sup>.</p>- +</ul><h4>Treatment and prognosis</h4><p>Oligoastroctyomas responded less favourably to chemotherapy due to the chemoresistance of their astrocytic component <sup>4</sup>. </p>
References changed:
- 9. Louis D, Perry A, Wesseling P et al. The 2021 WHO Classification of Tumors of the Central Nervous System: A Summary. Neuro Oncol. 2021;23(8):1231-51. <a href="https://doi.org/10.1093/neuonc/noab106">doi:10.1093/neuonc/noab106</a>
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