Gliomas: Difference between revisions
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= | {{NoteBox|secondary}}<strong>Related pages</strong> | ||
< | * [[Molecular markers in Gliomas]] | ||
{{NoteBoxEnd}} | |||
< | |||
= WHO 2016 Classification of Infiltrating Gliomas = | |||
<table class="wikitable"> | |||
<tr> | |||
<th>Diagnosis</th> | |||
<th>Common Mutations</th> | |||
<th>Additional Characteristics</th> | |||
</tr> | |||
<tr> | |||
<td colspan="3"><strong>[[Astrocytoma]]</strong></td> | |||
</tr> | |||
<tr> | |||
<td>[[Diffuse astrocytoma]], IDH-mutant (WHO grade II)</td> | |||
<td rowspan="7"> | |||
* IDH1/IDH2 | |||
* ATRX | |||
* TP53 | |||
* TERT promoter | |||
* EGFR amplification | |||
* +7/−10 | |||
* PTEN mutation/loss | |||
* H3.3 p.K27M</td> | |||
<td>Usually younger patients (40–50 years old); present as lower gliomas; most glioblastomas in this group are secondary</td> | |||
</tr> | |||
<tr> | |||
<td>Anaplastic astrocytoma, IDH-mutant (WHO grade III)</td> | |||
<td></td> | |||
</tr> | |||
<tr> | |||
<td>[[Glioblastoma]], IDH-mutant (WHO grade IV)</td> | |||
<td></td> | |||
</tr> | |||
<tr> | |||
<td>Diffuse astrocytoma, IDH-wildtype (WHO grade II)</td> | |||
<td>Usually older patients (>55 years old); present as high-grade gliomas; most glioblastomas in this group are primary</td> | |||
</tr> | |||
<tr> | |||
<td>Anaplastic astrocytoma, IDH-wildtype (WHO grade III)</td> | |||
<td></td> | |||
</tr> | |||
<tr> | |||
<td>Glioblastoma, IDH-wildtype (WHO grade IV)</td> | |||
<td></td> | |||
</tr> | |||
<tr> | |||
<td>Diffuse midline glioma, H3 -K27M-mutant</td><td>Midline location, infiltrating on histology, H3.3 p.K27M mutation</td></tr> | |||
<tr> | |||
<td colspan="3"><strong>[[Oligodendroglioma]]</strong></td> | |||
</tr> | |||
<tr> | |||
<td>Oligodendroglioma, IDH-mutant, 1p/19q codeleted (WHO grade II)</td> | |||
<td>IDH1/IDH2<br>1p/19q codeletion</td> | |||
<td>ATRX is wild-type (ATRX mutations are mutually exclusive with 1p/19q codeletion), strong correlation with perinuclear clearing histology</td> | |||
</tr> | |||
<tr> | |||
<td>Anaplastic oligodendroglioma, IDH-mutant, 1p/19q codeleted (WHO grade III)</td> | |||
<td></td> | |||
<td></td> | |||
</tr> | |||
</table> | |||
=Low Grade Glioma= | |||
<div class="mw-message-box-info mw-message-box"> | |||
==Outlines from Neurosurgery Self-assessment - Q&A== | |||
*1° goal in initial Tx of LGG is max. safe resection → assoc. w/ prolonged survival, sz pPx, ↓ risk of transformation; | *1° goal in initial Tx of LGG is max. safe resection → assoc. w/ prolonged survival, sz pPx, ↓ risk of transformation; | ||
*Qx for suspected LGGs challenges: | *Qx for suspected LGGs challenges: | ||
Line 11: | Line 73: | ||
**Histopathological undergrading is common w/ Bx, as LGG often exhibits focal areas of malignant transformation (anaplastic foci). To avoid this and reduce subsequent treatment failure, the surgical goal is to perform precise tissue sampling from a potential anaplastic focus. | **Histopathological undergrading is common w/ Bx, as LGG often exhibits focal areas of malignant transformation (anaplastic foci). To avoid this and reduce subsequent treatment failure, the surgical goal is to perform precise tissue sampling from a potential anaplastic focus. | ||
**"Eloquent" localization → awake Qx ± functional mapping | **"Eloquent" localization → awake Qx ± functional mapping | ||
</div> | </div> | ||
= High Grade Glioma = | |||
<hr> | |||
= | = Prognostic Factors = | ||
{{NoteBox|secondary}}The data from the pre-IDH era indicated a <u>poorer prognosis</u> associated w/ the following factors: | |||
* >40 y/o (most sig. unfavorable factor) | |||
* Hx of astrocytoma | |||
* SOL ≥6 cm | |||
* Crossing the midline | |||
* Preexisting deficit preQx {{NoteBoxEnd}} | |||
* | |||
* | |||
* | |||
* | |||
* | |||
[[Category:Neuro-Oncology]] | [[Category:Neuro-Oncology]] |
Latest revision as of 04:07, 5 March 2024
Related pages
WHO 2016 Classification of Infiltrating Gliomas
Diagnosis | Common Mutations | Additional Characteristics |
---|---|---|
Astrocytoma | ||
Diffuse astrocytoma, IDH-mutant (WHO grade II) |
|
Usually younger patients (40–50 years old); present as lower gliomas; most glioblastomas in this group are secondary |
Anaplastic astrocytoma, IDH-mutant (WHO grade III) | ||
Glioblastoma, IDH-mutant (WHO grade IV) | ||
Diffuse astrocytoma, IDH-wildtype (WHO grade II) | Usually older patients (>55 years old); present as high-grade gliomas; most glioblastomas in this group are primary | |
Anaplastic astrocytoma, IDH-wildtype (WHO grade III) | ||
Glioblastoma, IDH-wildtype (WHO grade IV) | ||
Diffuse midline glioma, H3 -K27M-mutant | Midline location, infiltrating on histology, H3.3 p.K27M mutation | |
Oligodendroglioma | ||
Oligodendroglioma, IDH-mutant, 1p/19q codeleted (WHO grade II) | IDH1/IDH2 1p/19q codeletion |
ATRX is wild-type (ATRX mutations are mutually exclusive with 1p/19q codeletion), strong correlation with perinuclear clearing histology |
Anaplastic oligodendroglioma, IDH-mutant, 1p/19q codeleted (WHO grade III) |
Low Grade Glioma
High Grade Glioma
Prognostic Factors
The data from the pre-IDH era indicated a poorer prognosis associated w/ the following factors:
- >40 y/o (most sig. unfavorable factor)
- Hx of astrocytoma
- SOL ≥6 cm
- Crossing the midline
- Preexisting deficit preQx