Glejaki

Glejaki are tumors that arise from glial cells in the brain and spinal cord. They encompass a range of histologies, including astrocytomas, oligodendrogliomas, and ependymomas, and are among the most common primary brain tumors in adults. The term is widely used in Polish medical literature to describe gliomas as a group.

Classification and molecular features have become central to the diagnosis and management of glejaki. The World Health Organization (WHO) classification groups tumors by histologic type and grade, from I to IV. Grade I tumors are typically slow-growing and often curable with surgery, while Grades II and III are considered low- to intermediate-grade gliomas. Grade IV gliomas, most commonly glioblastoma, are highly aggressive. In recent years, molecular markers such as IDH mutation status, 1p/19q co-deletion, and MGMT promoter methylation have become essential for prognosis and treatment decisions, with IDH-mutant and 1p/19q co-deleted oligodendrogliomas generally having a more favorable prognosis than IDH-wildtype tumors.

Epidemiology and pathophysiology vary by subtype. Glioblastoma is the most frequent high-grade glejak in adults and carries a relatively poor prognosis, with median survival around 12–15 months under standard therapy. Low-grade gliomas often present in younger patients and may have longer survival times, especially when favorable molecular markers are present. The pathogenesis involves genetic and epigenetic alterations in glial cells, leading to unchecked growth, infiltration, and resistance to therapy in higher-grade tumors.

Clinical presentation usually includes headaches, seizures, and focal neurological deficits, with symptoms reflecting tumor location. Diagnosis relies on magnetic resonance imaging with contrast, supported by histopathological examination and molecular profiling from biopsy or resection. Treatment typically combines maximal safe surgical resection, radiotherapy, and chemotherapy (notably temozolomide for high-grade tumors; PCV for certain oligodendrogliomas), while management strategies for low-grade tumors may emphasize watchful waiting or delayed radiotherapy. Prognosis is highly dependent on tumor type, grade, and molecular characteristics.