Pediatric Oligodendrogliomas

Abstract

Pediatric oligodendrogliomas are infrequently occurring brain tumors and frequently thought of as benign. The literature examining treatment and outcome in this select population is sparse. A retrospective analysis of pediatric oligodendrogliomas treated at MD Anderson Cancer Center between 1973 and 1992 was performed. Oligodendrogliomas were histologically graded according to the method of Smith. Survival data were estimated with Kaplan-Meier curves. Mean follow-up was 39.7 months. Nineteen children had histologically verified oligodendrogliomas and mixed oligodendroglioma/astrocytoma (M:F = 11:8; age range 1–18 years, mean = 13.1). Presenting symptoms included seizures (n = 10), headache (n = 3), visual field defects (n = 2), weakness (n = 2), cranial nerve palsy (n = 1) and decreased school performance (n = 1). All patients underwent craniotomy: 13 subtotal resections, 5 gross total resections and 1 biopsy. Twelve children had adjuvant therapy including radiation (n = 12), chemotherapy (n = 5) or both (n = 5). The 5-year survival was 65%. Seizure frequency was reduced in 30%. Children with oligodendrogliomas do not have a benign course, but younger children (<12 years) have a better prognosis. Histologic classification correlates with survival. Completeness of resection was not found to be a factor relating to survival. No conclusions can be drawn concerning adjuvant therapy because of selection bias.

Infratentorial oligodendroglioma in a child : case report and review of the literature

“…Oligodendrogliomas may occur at any age, but the initial diagnosis has two incidence peaks: 6-12 years and 35-44 years (14). Only about 7.5% of cases are diagnosed in children, representing a small proportion (about 1%) of childhood brain tumors (5,12). The tumor is somewhat more common in males, with sex-ratio ranging from 1.1 to 2.0 (5).…”

Seizures in Children with Brain Tumours — Epidemiology, Significance, Management, and Outcomes

“…This discovery is not unexpected, given the highly infiltrative nature of these tumours [77,96,97,191].…”

“…Virtually every possible tumour type has been reported presenting as seizures, especially lowgrade gliomas [27, 30, 32, 34, 37, 39, 70-72, 75, 76, 78, 91-93] and glioneuronal tumours like ganglioglioma and dysembryoplastic neuroepithelial tumour [28,44,62,73,88,89,91,94,95]; but including oligodendroglioma [77,96,97], cortical ependymoma [98], medulloblastoma [47], subependymal giant cell astrocytoma (SEGA) [99], meningioma [10] 0 , thalamic and cerebellar glioma [38,46], and a variety of atypical, systemic and metastatic tumours, like primary meningeal osteosarcoma [84], acute lymphoblastic leukemia [101], anaplastic large cell lymphoma [102], neuroblastoma [103], melanoma [104], various sarcomas [105,106], Ewing's sarcoma [107], malignant germ cell tumours [108], and others [16,109].…”

“…Overall, the series with the lowest total resection rates were those that included a number of oligodendrogliomas (ODG), with resection rates ranging from 30% in a study exclusively of ODG and ODG-mixed lesions [96] and 40% in an older study in which half the patients had ODG [219], to 58% and 61% in studies in which the proportion of ODG was considerably lower [90,220]. This discovery is not unexpected, given the highly infiltrative nature of these tumours [77,96,97,191].…”

Malignant Brain Tumors in Childhood

“…The generally circumscribed tumors occur most often in the cerebral hemispheres. Treatment recommendations are based largely on adult experience with S and RT (36). Adults show excellent response to procarbazine, lomustine, and vincristine (PCV) or to temozolomide CT, particularly in anaplastic oligodendrogliomas with isochromosome 1p or p53 mutations (37).…”