Medscape is available in 5 Language Editions – Choose your Edition here.


Oligodendroglioma Clinical Presentation

  • Author: ABM Salah Uddin, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
Updated: Jan 02, 2015


See the list below:

  • In prior years, a long delay occurred between symptom onset and diagnosis (as long as 29 y in some series). Because of earlier and better imaging availability, oligodendrogliomas have been diagnosed much earlier in recent years.
  • Like other intracranial space-occupying lesions, oligodendrogliomas present with focal cerebral dysfunction, depending on location, and rarely as increased intracranial pressure.
    • Most oligodendrogliomas present as a single lesion in the cerebral hemispheres.
    • Typically, they are cortical or subcortical; they rarely are found in deep gray structures, and occasionally they may be primarily intraventricular.
  • Rarely, they can occur infratentorially or in the spinal cord.
  • Occasionally they may be multifocal, like other gliomas.
  • The most common presenting symptom is seizure, observed at diagnosis in as many as half of patients. As many as 80% of patients have seizures at some time during their illness.
    • Depending on the location of the tumor, the seizure can be simple partial, complex partial, or generalized.
    • Previously undiagnosed oligodendrogliomas may be identified with medically refractory epilepsy.
  • Occasionally patients with oligodendrogliomas are brought to medical attention for headache, symptoms of increased intracranial pressure, or focal neurological deficits.
  • Tumors that arise within the ventricles may cause obstructive hydrocephalus and are more likely to disseminate through the cerebrospinal fluid (CSF). Rarely, they can metastasize outside the nervous system, especially the anaplastic oligodendroglioma.
  • In long-surviving patients with 1p/19q co-deletion, indolent leptomeningeal disease may be a complication of oligodendroglioma, which may have implications for the treatment.[2, 3]
  • Occasional patients present with strokelike transient ischemic attacks or with intracerebral hemorrhage.


Physical findings depend on the location of the tumor.

  • Frontal, parietal, and temporal lobe tumors most commonly present with seizures. Seizures may be simple, complex partial, and even generalized.
    • Frontoparietal tumors may present with hemiparesis and sensory neglect.
    • Sensory neglect is pronounced in right hemispheric lesions.
    • Temporal lobe tumors rarely may present with visual field defects, although patients may be unaware of hemianopsia.
  • Rare intraventricular oligodendroglioma may present with signs and symptoms of increased intracranial pressure such as headache, visual disturbance, and papilledema.
  • Posterior fossa oligodendrogliomas are uncommon. However, well-documented cases are described in children and may present with cerebellar ataxia and increased intracranial pressure.


No causes or risk factors are known. Occasional clustering occurs in some families, although the mode of inheritance is unknown. Patients with anaplastic oligodendrogliomas who have loss of heterozygosity on 1p or combined loss of heterozygosity on 1p and 19q survive substantially longer (mean, 10 y) than patients whose tumors lack these genetic changes (mean, 2 y).

Contributor Information and Disclosures

ABM Salah Uddin, MD Private Practice, Norwood Neurology; Consulting Staff, Department of Neurology, St Vincent's Hospital

ABM Salah Uddin, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, American Medical Association

Disclosure: Nothing to disclose.


Tambi Jarmi, MD Resident Physician, Department of Internal Medicine, Carraway Methodist Medical Center

Tambi Jarmi, MD is a member of the following medical societies: American College of Physicians, American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jorge C Kattah, MD Head, Associate Program Director, Professor, Department of Neurology, University of Illinois College of Medicine at Peoria

Jorge C Kattah, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, New York Academy of Sciences

Disclosure: Nothing to disclose.

Chief Editor

Stephen A Berman, MD, PhD, MBA Professor of Neurology, University of Central Florida College of Medicine

Stephen A Berman, MD, PhD, MBA is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, Phi Beta Kappa

Disclosure: Nothing to disclose.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Subramanian Hariharan, MD to the development and writing of this article.

  1. Elefante A, Peca C, Del Basso De Caro ML, Russo C, Formicola F, Mariniello G, et al. Symptomatic spinal cord metastasis from cerebral oligodendroglioma. Neurol Sci. 2011 Sep 17. [Medline].

  2. Roldan G, Scott J, George D, Parney I, Easaw J, Cairncross G. Leptomeningeal disease from oligodendroglioma: clinical and molecular analysis. Can J Neurol Sci. 2008 May. 35(2):204-9. [Medline].

  3. Li S, Yan C, Huang L, Qiu X, Wang Z, Jiang T. Molecular prognostic factors of anaplastic oligodendroglial tumors and its relationship: a single institutional review of 77 patients from China. Neuro Oncol. 2012 Jan. 14(1):109-16. [Medline]. [Full Text].

  4. Megyesi JF, Kachur E, Lee DH, et al. Imaging correlates of molecular signatures in oligodendrogliomas. Clin Cancer Res. 2004 Jul 1. 10(13):4303-6. [Medline].

  5. Brown R, Zlatescu M, Sijben A, Roldan G, Easaw J, Forsyth P. The use of magnetic resonance imaging to noninvasively detect genetic signatures in oligodendroglioma. Clin Cancer Res. 2008 Apr 15. 14(8):2357-62. [Medline].

  6. Yuen ST, Fung CF, Ng TH, Leung SY. Central neurocytoma: its differentiation from intraventricular oligodendroglioma. Childs Nerv Syst. 1992 Oct. 8(7):383-8. [Medline].

  7. Burger PC, Rawlings CE, Cox EB, et al. Clinicopathologic correlations in the oligodendroglioma. Cancer. 1987 Apr 1. 59(7):1345-52. [Medline].

  8. van den Bent MJ. Advances in the biology and treatment of oligodendrogliomas. Curr Opin Neurol. 2004 Dec. 17(6):675-80. [Medline].

  9. van den Bent MJ, Carpentier AF, Brandes AA, Sanson M, Taphoorn MJ, Bernsen HJ, et al. Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial. J Clin Oncol. 2006 Jun 20. 24(18):2715-22. [Medline].

  10. Cairncross G, Macdonald D, Ludwin S, et al. Chemotherapy for anaplastic oligodendroglioma. National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 1994 Oct. 12(10):2013-21. [Medline].

  11. van den Bent MJ, Taphoorn MJ, Brandes AA, et al. Phase II study of first-line chemotherapy with temozolomide in recurrent oligodendroglial tumors: the European Organization for Research and Treatment of Cancer Brain Tumor Group Study 26971. J Clin Oncol. 2003 Jul 1. 21(13):2525-8. [Medline]. [Full Text].

  12. Mohile NA, Forsyth P, Stewart D, Raizer JJ, Paleologos N, Kewalramani T, et al. A phase II study of intensified chemotherapy alone as initial treatment for newly diagnosed anaplastic oligodendroglioma: an interim analysis. J Neurooncol. 2008 Sep. 89(2):187-93. [Medline].

  13. Cairncross JG, Berkey B, Shaw E. Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic oligodendrogliomas: intergroup Radiation Therapy Oncology Group Trial 9402. J Clin Oncol. 2006. 24:2702-2714.

  14. Shaw EG, Wang M, Coons SW, Brachman DG, Buckner JC, Stelzer KJ, et al. Randomized Trial of Radiation Therapy Plus Procarbazine, Lomustine, and Vincristine Chemotherapy for Supratentorial Adult Low-Grade Glioma: Initial Results of RTOG 9802. J Clin Oncol. 2012 Jul 30. [Medline].

  15. Daumas-Duport C, Scheithauer BW, Chodkiewicz JP, et al. Dysembryoplastic neuroepithelial tumor: a surgically curable tumor of young patients with intractable partial seizures. Report of thirty-nine cases. Neurosurgery. 1988 Nov. 23(5):545-56. [Medline].

  16. Bello MJ, Vaquero J, de Campos JM, et al. Molecular analysis of chromosome 1 abnormalities in human gliomas reveals frequent loss of 1p in oligodendroglial tumors. Int J Cancer. 1994 Apr 15. 57(2):172-5. [Medline].

  17. Celli P, Nofrone I, Palma L, et al. Cerebral oligodendroglioma: prognostic factors and life history. Neurosurgery. 1994 Dec. 35(6):1018-34; discussion 1034-5. [Medline].

  18. Han SR, Yoon SW, Yee GT, Choi CY, Lee DJ, Sohn MJ, et al. Extraneural metastases of anaplastic oligodendroglioma. J Clin Neurosci. 2008 Aug. 15(8):946-9. [Medline].

  19. Hartmann C, von Deimling A. Oligodendrogliomas: impact of molecular genetics on treatment. Neurol India. 2005 Jun. 53(2):140-8. [Medline].

  20. Kang SG, Kim JH, Nam do H, Park K. Clinical and radiological prognostic factors of anaplastic oligodendroglioma treated by combined therapy. Neurol Med Chir (Tokyo). 2005 May. 45(5):232-8; discussion 238-9. [Medline].

  21. Kaye AH, Laws ER Jr, eds. Brain Tumors: An Encyclopedic Approach. New York: Churchill Livingstone; 1995. 479-91.

  22. Kleihus P, Cavenee WK. Pathology and Genetics of Tumours of the Nervous System. New York: Oxford University Press; 2000. 56-64.

  23. Mason WP. Oligodendroglioma. Curr Treat Options Neurol. 2005 Jul. 7(4):305-314. [Medline].

  24. Mason WP, DeAngelis LM. Procarbazine, CCNU, vincristine (PCV) chemotherapy for benign oligodendroglioma. Neurology. 1994. 44(Suppl 2):A262-A263.

  25. Packer RJ, Sutton LN, Rorke LB, et al. Oligodendroglioma of the posterior fossa in childhood. Cancer. 1985 Jul 1. 56(1):195-9. [Medline].

  26. Paleologos NA, Vick NA, Kachoris JP. Chemotherapy for low grade oligodendrogliomas. Ann Neurol. 1994. 36:294-295.

  27. Pitt MA, Jones AW, Reeve RS, Cowie RA. Oligodendroglioma of the fourth ventricle with intracranial and spinal oligodendrogliomatosis: a case report. Br J Neurosurg. 1992. 6(4):371-4. [Medline].

  28. Sarkar C, Roy S, Tandon PN. Oligodendroglial tumors. An immunohistochemical and electron microscopic study. Cancer. 1988 May 1. 61(9):1862-6. [Medline].

  29. Schold SC, Burger PC, Minna JD, et al. Primary Tumors of the Brain and Spinal Cord. Boston: Butterworth Heinemann; 1997. 71-82.

  30. van den Bent MJ, Afra D, de Witte O, et al. Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet. 2005 Sep 17-23. 366(9490):985-90. [Medline].

  31. Wen PY, Black PM. Brain Tumors in Adults. Neurol Clin. 1995. 13:861-873.

Classic histologic image of oligodendroglioma. This image shows monomorphous tumoral proliferation that consists of round, regular cells with a small, central, hyperchromatic nucleus surrounded by clear cytoplasm. Few calcifications are present.
Smear preparation of anaplastic oligodendroglioma. This image reveals increased nuclear pleomorphism and vascular proliferation.
Contrast-enhanced computed tomography scan in a 44-year-old man with a 3-year history of epileptic seizures. This image reveals a calcified hypoattenuating lesion that is invading the corpus callosum.
Computed tomography scan of a low-grade oligodendroglioma. This image reveals a well-demarcated, left frontal hypoattenuating lesion with a small calcification.
Sagittal gadolinium-enhanced T1-weighted magnetic resonance image of a low-grade oligodendroglioma. This image demonstrates no contrast enhancement.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.