Glioma

• Glioma:

  • Umbrella term for type of primary brain tumour that starts in the glial cells of the brain or spinal cord
  • Includes a variety of different tumours: astrocytomas, glioblastoma multiforme (GBM), pilocytic astrocytoma (PCA), ependymomas and oligodendrogliomas
• Epidemiology:

  • Account for 50% of primary brain tumours in adults
  • More common in men
  • Mean age of onset is 55
• All gliomas metastasise via the cerebrospinal fluid
• Clinical features include:

  • Headache
  • Vomiting
  • Seizures
  • Focal neurological deficit including visual loss
  • Cranial nerve dysfunction
• Relevant investigations include:

  • MRI with gadolinium contrast
• Management:

  • Surgery - complete resection is often challenging due to the margins between the tumour and brain are rarely clear
  • Radiotherapy - targeted radiotherapy to shrink tumours or to destroy any residual tumour cells after excision
  • Chemotherapy - temozolomide has been shown to increase survival when given alongside surgery and/or radiotherapy
• Prognosis:

  • Overall the prognosis is poor as gliomas are rarely curable
  • GBMs have a life expectancy of 1 year
  • PCAs are an exception - 5 year survival rare of over 95%