Clinical presentation of spinal oligodendrogliomas

Abstract Initially defined in 1926 by Bailey and Cushing, oligodendrogliomas are exceedingly rare gliomas arising from oligodendrocytes. Spinal oligodendrogliomas are even rarer still representing 1.59% of all oligodendrogliomas with only 60 cases reported in the literature. There is a mild predilection toward males (1.33 times more likely to occur in males than in females), and these tumors are 2.5 times more prevalent in Caucasians compared to African-American populations. Clinical presentation of spinal oligodendroglioma is often dependent on the location of the tumor and age of presentation. The majority of spinal oligodendrogliomas arise in the thoracic region (36.3%), followed by the lumbar (18.2%), cervical (18%), thoracolumbar (12.1%), cervicothoracic (9.1%) regions, and the whole spinal cord (8%). The average size of a primary oligodendroglioma is 3.5 (± 1.8) vertebral levels. The most common presenting symptoms are weakness/paresis (69.5%), pain—including acute back pain, neck pain, and sciatic pain (50%), and sensory changes—including paresthesia and numbness (45%). In addition to the location of the tumor in the spinal cord, exhibiting signs also depend on whether the tumor is intramedullary, intradural-extramedullary, or extramedullary. The typical age of presentation is between 30 and 40 years, with the majority of patients presenting in adulthood. Spinal oligodendrogliomas in the pediatric population tend to present as scoliosis, regression of motor developmental milestones, gait disturbance, and sensory deficits. Patients presenting with a history of symptoms referable to the spinal cord and/or a concerning neurological exam should undergo prompt imaging with an MRI (magnetic resonance imaging) of the spine with and without contrast.