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CASE REPORT
Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 61-66

Multicentric anaplastic oligodendroglioma involving supra- and infratentorial regions: Glioma aplenty!


1 Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, India
2 Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, India
3 Department of Neuroradiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
4 Kidwai Memorial Institute of Oncology, Bengaluru, India

Correspondence Address:
Dr. Arimappamagan Arivazhagan
Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJNO.IJNO_21_21

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Background: Multicentric gliomas are an uncommon entity and are mostly of astrocytic lineage and rarely oligodendrogliomas (ODGs). Multicentric ODGs are very rare, mostly comprising of two to three lesions. Here, we describe a case of multicentric ODG, with varying histological grades with at least six distinct lesions involving six different regions of the brain.Case Report: A 33-year-old gentleman presented with features of raised intracranial pressure and acute onset altered sensorium. Magnetic resonance imaging (MRI) of the brain revealed multiple lesions involving both cerebral (bilateral frontal and temporal lobes) and cerebellar hemispheres. The patient underwent surgical decompression of two of the lesions which were causing significant mass effect, after which his symptoms improved. Interestingly, both lesions demonstrated ODG histology but with different grades, with one being Grade II and the other being a Grade III lesion. Following surgery, he received adjuvant radiotherapy and chemotherapy with temozolomide. His follow-up MRI brain performed 5 months after surgery showed no recurrence at the operated sites and no increase in size of the remaining lesions.Conclusion: Surgical management of multicentric glioma needs individualized strategy with multidisciplinary care and involves maximal safe resection of large tumors with consideration of biopsy from smaller lesions for histomolecular diagnosis and adjuvant therapy.


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