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Oligoastrocytoma NOS

Case contributed by Hani Makky Al Salam
Diagnosis almost certain

Presentation

A young male patient presented with seizure

Patient Data

Age: Young adult
Gender: Male
mri

A left interior frontal gyrus mass demonstrates high T2 signal, facilitated diffusion, and no convincing contrast enhancement. 

Nuclear medicine

PET scan demonstrates no convincingly elevated activity. 

Case Discussion

Path proven oligoastrocytoma (NOS), predominantly astrocytoma WHO grade II

NOTE: This case predates the 2016 WHO classification of CNS tumor revision. As no 1p19q co-deletion status is available a formal diagnosis cannot be reached and the NOS is therefore used (not otherwise specified) - which is recognized in the current classification for cases where molecular information is unavailable. It should also be noted, that under the new classification both an astrocytic and oligodendroglial component needs to be identified, each with its own molecular markers. True oligoastrocytomas are therefore going to be rare, and this case would most likely be classified as either an astrocytoma or an oligodendroglioma. Given extensive calcification, this is likely to be 1p19q co-deleted and most likely would be classified as an oligodendroglioma. Unfortunately, it is not possible to establish this in this historical case, as such one must fall back on the original histological diagnosis. 

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