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oligodendroglioma

Oligodendroglioma

Epidemiology

Classification

Etiology

Variants at 8q24.21 have been shown to be associated with glioma development. By means of tag SNP genotyping and imputation, pooled next-generation sequencing using long-range PCR and subsequent validation SNP genotyping, we identified seven low-frequency SNPs at 8q24.21 that were strongly associated with glioma risk (P=1×10(-25) to 1×10(-14)). The most strongly associated SNP, rs55705857, remained highly significant after individual adjustment for the other top six SNPs and two previously published SNPs. After stratifying by histological and tumor genetic subtype, the most significant associations of rs55705857 were with oligodendroglial tumors and gliomas with mutant IDH1 or IDH2 (odds ratio (OR)=5.1, P=1.1×10(-31) and OR=4.8, P=6.6×10(-22), respectively). Strong associations were observed for astrocytomas with mutated IDH1 or IDH2 (grades 2-4) (OR=5.16-6.66, P=4.7×10(-12) to 2.2×10(-8)) but not for astrocytomas with wild-type IDH1 and IDH2 (smallest P=0.26). The conserved sequence block that includes rs55705857 is consistently modeled as a microRNA 2).

Findings suggest a possible participation of rs891835, rs6470745, and rs55705857 as risk factors to develop glioma 3).

Tumor DNA may approximate genotype at the rs55705857 locus. Hummel et al., confirmed this locus confers an increased risk of all cancers and especially of oligodendroglioma. No increased cancer or brain tumor risk is seen in family members of individuals without the high-risk G allele 4).

Some studies have linked oligodendroglioma with a viral cause. A 2009 Oxford Neurosymposium study illustrated a 69% correlation between NJDS gene mutation and the tumor initiation shown by Kevin Smith. A single case report has linked oligodendroglioma to irradiation of pituitary adenoma.

Pathology

For nearly a century, the diagnosis and grading of oligodendrogliomas and oligoastrocytomas has been based on histopathology alone.The first glioma-associated molecular signature was found with complete chromosome 1p and 19q codeletion being particularly common in histologically classic oligodendrogliomas. Subsequently, this codeletion appeared to not only carry diagnostic, but also prognostic and predictive information, the latter aspect only recently resolved after carefully constructed clinical trials with very long follow-up times. More recently described biomarkers, including the non-balanced translocation leading to 1p/19q codeletion, promoter hypermethylation of the MGMT gene, mutations of the IDH1 or IDH2 gene, and mutations of FUBP1 (on 1p) or CIC (on 19q), have greatly enhanced our understanding of oligodendroglioma biology, although their diagnostic, prognostic, and predictive roles are less clear. It has therefore been suggested that complete 1p/19q codeletion be required for the diagnosis of 'canonical oligodendroglioma'. This transition to an integrated morphological and molecular diagnosis may result in the disappearance of oligoastrocytoma as an entity, but brings new challenges as well. For instance it needs to be sorted out how (histopathological) criteria for grading of 'canonical oligodendrogliomas' should be adapted, how pediatric oligodendrogliomas (known to lack codeletions) should be defined, which platforms and cut-off levels should ideally be used for demonstration of particular molecular aberrations, and how the diagnosis of oligodendroglioma should be made in centers/countries where molecular diagnostics is not available. Meanwhile, smart integration of morphological and molecular information will lead to recognition of biologically much more uniform groups within the spectrum of diffuse gliomas and thereby facilitate tailored treatments for individual patients 5).

Clinical features

In anywhere from fifty to eighty percent of cases, the first symptom of an oligodendroglioma is the onset of seizure activity. They occur mainly in the frontal lobe. Headaches combined with increased intracranial pressure are also a common symptom of oligodendroglioma. Depending on the location of the tumor, any neurological deficit can be induced, from visual loss, motor weakness and cognitive decline.

Diagnosis

Differential diagnosis

In rare cases, without conclusive data on IDH mutation and 1p/19q codeletion status, tumours are classified as oligodendroglioma, not otherwise specified. The diagnosis of oligoastrocytoma is discouraged in the new WHO classification, which states that only exceptional cases that cannot be conclusively tested for IDH mutation and 1p/19q codeletion that show a mixed oligoastrocytic histology can still be classified as oligoastrocytoma, not otherwise specified 6).

Treatment

Outcome

Case reports

A 83-year-old man with an 11-year history of lentigo maligna melanoma who presented with impaired balance and cognitive slowing and was found to have rapid progression of a previously known indolent right frontal brain mass. Pathologic examination of the tumor after resection revealed the presence of both malignant melanoma and an oligodendroglioma WHO grade II. To the best of our knowledge, this is the first reported case of malignant melanoma metastasizing to an oligodendroglioma that has been confirmed by immunohistochemistry and genetic analysis 7).

1) , 6)
Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 2016; 131: 803–20
2)
Jenkins RB, Xiao Y, Sicotte H, Decker PA, Kollmeyer TM, Hansen HM, Kosel ML, Zheng S, Walsh KM, Rice T, Bracci P, McCoy LS, Smirnov I, Patoka JS, Hsuang G, Wiemels JL, Tihan T, Pico AR, Prados MD, Chang SM, Berger MS, Caron AA, Fink SR, Halder C, Rynearson AL, Fridley BL, Buckner JC, O'Neill BP, Giannini C, Lachance DH, Wiencke JK, Eckel-Passow JE, Wrensch MR. A low-frequency variant at 8q24.21 is strongly associated with risk of oligodendroglial tumors and astrocytomas with IDH1 or IDH2 mutation. Nat Genet. 2012 Oct;44(10):1122-5. doi: 10.1038/ng.2388. Epub 2012 Aug 26. PubMed PMID: 22922872; PubMed Central PMCID: PMC3600846.
3)
González-Castro TB, Juárez-Rojop IE, López-Narváez ML, Tovilla-Zárate CA, Genis-Mendoza AD, Pérez-Hernández N, Martínez-Magaña JJ, Rodríguez-Pérez JM. Genetic Polymorphisms of CCDC26 rs891835, rs6470745, and rs55705857 in Glioma Risk: A Systematic Review and Meta-analysis. Biochem Genet. 2019 Feb 18. doi: 10.1007/s10528-019-09911-7. [Epub ahead of print] PubMed PMID: 30778791.
4)
Hummel S, Kohlmann W, Kollmeyer TM, Jenkins R, Sonnen J, Palmer CA, Colman H, Abbott D, Cannon-Albright L, Cohen AL. The contribution of the rs55705857 G allele to familial cancer risk as estimated in the Utah population database. BMC Cancer. 2019 Mar 1;19(1):190. doi: 10.1186/s12885-019-5381-2. PubMed PMID: 30823903.
5)
Wesseling P, van den Bent M, Perry A. Oligodendroglioma: pathology, molecular mechanisms and markers. Acta Neuropathol. 2015 Jun;129(6):809-27. doi: 10.1007/s00401-015-1424-1. Epub 2015 May 6. Review. PubMed PMID: 25943885; PubMed Central PMCID: PMC4436696.
7)
Giantini Larsen A, Grannan BL, Lee CK, Koch MJ, Williams EA, Frosch MP, Cahill DP. Malignant Melanoma Metastatic to Oligodendroglioma: Case Report and Literature Review of Tumor-to-Tumor Metastasis to Gliomas. J Neuropathol Exp Neurol. 2018 May 8. doi: 10.1093/jnen/nly029. [Epub ahead of print] PubMed PMID: 29746652.
oligodendroglioma.txt · Last modified: 2019/03/04 16:36 by administrador