Spinal oligodendroglioma: a > 70-year systematic review of current literature

Primary spinal oligodendrogliomas (sODGs) are an exceptionally rare subset of oligodendrogliomas (ODGs). As such, there is a limited understanding of their natural history, optimal treatment approaches, and long-term outcomes. This systematic review aimed to better characterize the presentation and management of sODGs.

Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was performed using the PubMed, EMBASE, Web of Science, and Cochrane databases from inception to December 2024. The review included case reports and case series, and data extraction focused on patient demographics, clinical presentation, diagnostic features, treatment modalities, and outcomes.

The review identified 38 sODG cases from 33 studies. The median age at diagnosis was 22.5 years, with a male predominance (57.9%). Common presenting symptoms included extremity weakness (59.4%), back pain (25%), and sensory deficits (25%). MRI was the primary diagnostic tool (76.7%). Resection was the primary treatment, with 36.7% achieving total resection. Adjuvant therapy was administered to 57.1% of patients. The recurrence or progression rate was 52.2%, with a median follow-up of 28.5 months.

Spinal ODGs present unique challenges in diagnosis, management, and prognosis compared with their cranial counterparts. The findings support considering sODGs in the differential diagnosis for patients with progressive myelopathic symptoms in the absence of obvious compressive spondylosis. Future research should focus on long-term outcomes, optimal treatment strategies, and molecular characterization of these rare tumors.