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Metastatic anaplastic oligodendroglioma
D R Macdonald1, R A O'Brien, J J Gilbert
1Department of Clinical Neurological Sciences, Victoria Hospital, University of Western Ontario, London, Canada.
Abstract:
We report 7 patients, ages 21 to 49 years, with systemic metastasis from anaplastic oligodendroglioma. Metastases developed in the scalp, cervical lymph nodes, bone, and other organs 1 to 76 months after the most recent surgery and 18 to 86 months after diagnosis. Systemic metastases responded to focal radiotherapy or nitrosourea-based chemotherapy for 6 to 18 months. Five patients have died, 4 to 24 months after the appearance of systemic metastases, all with progressive cerebral and systemic tumor. We observed 2 distinct patterns of spread of oligodendroglioma. Pattern 1, initial scalp or regional lymph node involvement followed by distant metastasis, was associated with multiple craniotomies. Pattern 2, distant metastasis without scalp or regional lymph node spread, was associated with early radiotherapy and chemotherapy. Longer-than-expected survival was not essential to metastasis. We speculate that anaplastic oligodendrogliomas possess special characteristics favoring metastasis and that early aggressive treatment alters the biology of this disease.
Insights
Anaplastic oligodendroglioma can spread to distant organs, even after successful treatment. Early aggressive therapies may alter the disease
Area of Science:
- Neuro-oncology
- Cancer Metastasis Research
- Clinical Neurology
Background:
- Anaplastic oligodendroglioma is a primary brain tumor.
- Systemic metastasis is a rare but serious complication.
Observation:
- Seven patients (ages 21-49) with anaplastic oligodendroglioma developed systemic metastases.
- Metastases appeared in scalp, lymph nodes, bone, and other organs 1-76 months post-surgery.
- Two distinct patterns of tumor spread were identified.
Findings:
- Systemic metastases showed a 6-18 month response to radiotherapy or nitrosourea chemotherapy.
- Five patients died from progressive cerebral and systemic disease.
- Metastasis patterns correlated with treatment history: Pattern 1 (local spread first) with multiple surgeries, Pattern 2 (distant spread first) with early systemic therapy.
Implications:
- Anaplastic oligodendrogliomas may have inherent metastatic potential.
- Aggressive early treatment might influence the metastatic behavior of these tumors.
- Further research into the biology of oligodendroglioma metastasis is warranted.