gms | German Medical Science

Objective: Oligodendrogliomas are common neoplasms in the supratentorial space but only rarely found in cerebellum and the brainstem. Biological behaviour of oligodendrogliomas seem different depending on the primary location of the tumor. Reviewing the course of disease and treatment in a girl and an adult lady we focus on special features of the tumor arising in the posterior fossa.

Method: Clinical, pathological and radiological findings of 2 patients were reviewed. T.H. was operated at the age of 11 years and N.P. at the age of 59. Both patients have been examined clinically and radiologically only recently. Clinical and radiological follow-up is performed in the same institution and complete. So also the further course of the disease can be followed.

Results: T.H. was operated for a cerebellar oligodendroglioma WHO °I first at the age of 11 years presenting with signs of obstructive hydrocephalus due to the space occupying lesion in the posterior fossa. Partial removal was achieved first in 2 subsequent operations. The girl received radiation afterwards. With signs of further progression another operation was done 14 months after the first intervention and afterwards the girl received chemotherapy. Dignity of the tumor didn’t change and the girl is now 26-year-old and in training to become a nurse. MRI shows no hints for recurrence. P.N., a lady 59 years of age at the time of hospital admission was under anticoagulation for activated protein C resistance. She had no neurological symptoms before. She arrived in coma and CT showed a large intracerebellar hemorrhage with a calcified and partly cystic appearing tumor within the large space occupying lesion. The tumor eventually turned out to be an oligodendroglioma WHO °II. She recovered only slowly and she is still not fully awake and unable to walk and stand alone. MRI controls now show signs of recurrence 5 months after the operation while the MRI scans performed early after the operation showed no definite residual tumor.

Conclusions: Oligodendrogliomas especially in the posterior fossa represent an obviously very different tumor entity with respect to clinical, radiological and intraoperative aspects. As in other brain tumors questions referring to prognosis should be handled with particular care. The course of the disease may differ completely from what is expected as shown in the case of the young girl T.H.