Revista argentina de neurocirugía
versión On-line ISSN 1850-1532
SUAREZ, Julio César et al. Gliomas cerebrales de bajo grado en el adulto. Rev. argent. neurocir. [online]. 2008, vol.22, n.1, pp. 0-0. ISSN 1850-1532.
Objective. Gliomas reviewed in this article are grade II tumors according to the World Health Organization (WHO), that include: fibrillary and protoplasmic astrocytomas, oligodendrogliomas and oligoastrocytomas or mix tumors (1,2,3).Low grade astrocytomas constitute 15% of brain tumors in adults, while low grade oligodendrogliomas represent 4% (2,4). We present our experience with this type of tumor operated on between January 1972 and December 2006. Material and Method. The clinical reports of 25 patients with this type of tumor were analyzed, 15 women and 10 men, which represent 15,6% of hemispheric brain gliomas in adults in our series. Results. Fifteen were fibrillary astrocytomas, 8 oligodendrogliomas and 2 oligoastrocytomas. Treatment depended on tumor localization and size. Surgery and radiotherapy were the therapeutic modalities most frequently used. Tumor recurrence was observed in 16 patients, with a media of 37+/- 21 months after diagnosis: 7 anaplastic astrocytomas and 9 glioblastomas multiforme. In this series, 16 patients died with a median of 44 months (10 days to 120 months) after diagnosis. Cause of death were: tumor itself, in 14 cases, tongue cancer in 1, and pulmonary embolism after surgery in another. From the 9 surviving patients, 6 have oligodendrogliomas, 2 astrocytomas and 1 an oligoastrocytoma. Seven patients need antiepileptic drug and none of them presents neurological sequels. The survival mediana was 36 months (6 to 120 months). Two of them had two recurrences between 22 and 60 months after diagnosis, one oligodendroglioma and the other an oligoastrocytoma; in both cases tumors grade II became tumors grade III. Conclusion. The relative incidence of 15,6% in adult gliomas of our series is similar to the international experience. Age, younger as 40 years, seizures, as clinical presentation, extension of surgical resection, low Ki 67 index in astrocytomas, and loss of chromosome 1p and 19q in oligodendrogliomas are favorable prognostic factors. IRM standard, with gadoline, with spectroscopy and functional is the main image study for diagnosis, and inmunohistochimestry together with molecular biology studies are important for tumor prognosis.
Palabras clave : Low grade gliomas; Cerebral tumors.