glioomat

Glioomat, or gliomas, are a group of tumors that originate from glial cells in the brain or spinal cord. They are typically infiltrative and can involve neighboring brain tissue, influencing both symptoms and treatment. Gliomas are traditionally categorized by histology into astrocytomas, oligodendrogliomas, and ependymomas, with pilocytic astrocytoma representing a slower-growing, well-circumscribed low-grade form. In modern practice, the World Health Organization’s CNS5 classification integrates molecular features with histology, recognizing subtypes defined by genetic changes such as IDH mutations and 1p/19q codeletion.

Key molecular markers include IDH mutation status, 1p/19q codeletion, and MGMT promoter methylation. IDH-mutant gliomas generally have a better prognosis than IDH-wildtype tumors, and 1p/19q codeletion defines oligodendrogliomas with distinct clinical behavior and treatment responses. MGMT promoter methylation is associated with greater sensitivity to alkylating chemotherapy in some gliomas.

Symptoms depend on tumor location and size and may include seizures, persistent headaches, cognitive or personality changes, and focal neurological deficits. Diagnosis relies on magnetic resonance imaging (MRI) with contrast, sometimes supplemented by advanced imaging techniques, followed by histopathological and molecular analysis from biopsy or resection tissue.

Treatment is individualized by type and grade. The goal is maximal safe surgical resection when feasible, followed by radiotherapy and chemotherapy. Oligodendrogliomas with 1p/19q codeletion and IDH mutation often receive combined radiotherapy with PCV chemotherapy; glioblastomas or IDH-wildtype high-grade gliomas commonly use radiotherapy with temozolomide. Recurrence is common, and management may include repeat surgery, anti-edema therapy, re-irradiation, or targeted/systemic therapies.

Prognosis varies widely by grade and molecular profile; low-grade, IDH-mutant gliomas may have long survival, while high-grade, IDH-wildtype tumors tend toward poorer outcomes. Gliomas are relatively uncommon in the general population but are a leading category of primary brain tumors.