Grand Rounds_Oligoastrocytoma_powerpoint pdf<\/a><\/p>\nOligoastrocytoma<\/p>\n
Oligoastrocytomas are brain tumors that consist of oligodendrocytes and astrocytes, the two cell types in the brain that support and insulate nerve cells. Unlike many brain tumors, which typically present initially with headaches, seizures are a common initial symptom of oligoastrocytomas.<\/p>\n
The patient presented with episodes of \u201ca feeling of walking through a cloud,\u201d receptive, or Wernicke\u2019s aphasia (the inability to understand spoken words), Aphasia (inability to speak), and vertigo. She also suffered from brief seizures, which worsened in severity over the course of the next eight years, and began to involve loss of consciousness and muscle tone, occasional incontinence, and overwhelming confusion. Three months prior to admittance, the patient struck her head during an episode, but MRI, ECG, echocardiography, Holter monitoring, EEG and multiple blood tests all appeared normal. The patient did not respond to triptans or beta-blockers, but the frequency of her seizures increased to at least one per day.<\/p>\n
An MRI was performed on the patient, which showed a mass in the left occipitotemporal region of the brain. A biopsy helped to determine the grade of the tumor \u2013 grade II, which is a low grade tumor \u2013 and also presents the pathology which helps to determine the growth patterns of the tumor cells. Fluorescence in situ hybridization (FISH), which allows for reliable and accurate detection of chromosomal deletions, showed deletions in 1p and 19q tumors.<\/p>\n
Similar to most tumors, the exact cause of an oligoastrocytoma is unknown. It is understood that normal cells become abnormal in the sense that they may produce the wrong number of proteins or enzymes or be lacking certain genetic material. In the case of an oligoastrocytoma, deletions of genetic information in chromosomes 1p and 19q are the reason for the tumor cell\u2019s abnormalities. This certain type of tumor is a result of a mixture of oligodendrocytes and astrocytes. Genetic material losses in 19q occur in 60-80% of oligodendrogliomas and 30-40% in astrocytomas, which demonstrate that there may be a shared variation in the formation of gliomas. Losses in the 1p chromosome are frequent with oligodendrogliomas at about 50-80%, however are less apparent with astrocytomas, which is detected only 10-18% of the time. However, the combination of genetic material losses of the 1p and 19q chromosomes is detected in 60-80% of oligoastrocytoma cases.<\/p>\n
A gross resection was performed to remove the patient\u2019s low-grade oligoastrocytoma tumor. Standard radiotherapy and antiepileptic medications were given after the resection. Lifelong MRI was suggested instead of permanent pacemaker due to the low-grade of the tumor. Following MRI shows only postsurgical changes, implying good prognosis. During the 24-month following the resection, no seizure has occurred with reduction in medication, indicating great possibility of freedom from seizure in 10 years and absence of intractability.<\/p>\n
The patient\u2019s case is complicated by ictal asystole (stopping of the heart during her epileptic seizures, which is very rare) in a patient with a predisposition to neurocardiogenic syncope (fainting, loss of consciousness, loss of muscle tone due to an abnormal control mechanism of the brain over the heart) due to a genetic disorder, and with the asystole being triggered by the seizures caused by her oligoastrocytoma make this case very interesting and unique. The important information the case conveys is that a patient\u2019s symptoms are not always indications of a single disease, and sometimes the symptoms need to be closely examined and can suggest more than one disease. Perhaps screening for relationships between cardiac dysfunction and neurologic mechanisms could help identify rare cases such as this one, which would allow for earlier diagnosis and treatment.<\/p>\n
References:<\/p>\n
(1) Paleologos, N A, ed. Oligodendroglioma and Oligoastrocytoma. Am Br Tum Assoc 2014: 3-8.<\/p>\n
(2) Oligoastrocytoma. Univ CO Sch of Med Neusrgy 2015.<\/p>\n
(3) Meenakshi G, MD, Azita Djalilvand, MD, Daniel J. Brat, MD, PhD. Clarifying the Diffuse Gliomas. Am J Clin Pathol. 2005;124(5):755-768.<\/p>\n
(4) Cole, AJ, M.D., Eskandar, E. M.D., Mela, T, M.D., Noebels, J.L. M.D., Ph.D., Gonzalez, R.G. M.D., Ph.D., McGuone, D, M.B., Ch.B. Case 18-2013 \u2014 A 32-Year-Old Woman with Recurrent Episodes of Altered Consciousness. N Engl J Med 2013; 368:2304-2312.<\/p>\n
(5) Ucdenver.edu. Department of Neurosurgery [Internet]. 2015 [cited 2015 Jan 15]; Available from:http:\/\/www.ucdenver.edu\/academics\/colleges\/medicalschool\/departments\/Neurosurgery\/patientcare\/multi-disciplinaryprograms\/AdultBrainTumorProgram\/Pages\/Oligoastrocytoma.aspx<\/p>\n
<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Grand Rounds: Oligoastrocytoma Alex Lucas, Yvette Qu, Rachel Bird Grand Rounds_Oligoastrocytoma_powerpoint pdf Oligoastrocytoma Oligoastrocytomas are brain tumors that consist of oligodendrocytes and astrocytes, the two cell types in the brain that support and insulate nerve cells. Unlike many brain tumors, which typically present initially with headaches, seizures are a common initial symptom of oligoastrocytomas. […]<\/p>\n","protected":false},"author":5245,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"footnotes":""},"categories":[145196],"tags":[145243,145241,145242],"_links":{"self":[{"href":"https:\/\/web.colby.edu\/bi265-humananatomyatcolby\/wp-json\/wp\/v2\/posts\/440"}],"collection":[{"href":"https:\/\/web.colby.edu\/bi265-humananatomyatcolby\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/web.colby.edu\/bi265-humananatomyatcolby\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/web.colby.edu\/bi265-humananatomyatcolby\/wp-json\/wp\/v2\/users\/5245"}],"replies":[{"embeddable":true,"href":"https:\/\/web.colby.edu\/bi265-humananatomyatcolby\/wp-json\/wp\/v2\/comments?post=440"}],"version-history":[{"count":3,"href":"https:\/\/web.colby.edu\/bi265-humananatomyatcolby\/wp-json\/wp\/v2\/posts\/440\/revisions"}],"predecessor-version":[{"id":447,"href":"https:\/\/web.colby.edu\/bi265-humananatomyatcolby\/wp-json\/wp\/v2\/posts\/440\/revisions\/447"}],"wp:attachment":[{"href":"https:\/\/web.colby.edu\/bi265-humananatomyatcolby\/wp-json\/wp\/v2\/media?parent=440"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/web.colby.edu\/bi265-humananatomyatcolby\/wp-json\/wp\/v2\/categories?post=440"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/web.colby.edu\/bi265-humananatomyatcolby\/wp-json\/wp\/v2\/tags?post=440"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}