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Chapter 12 - Glioma

from Section 2 - Clinical Neurosurgical Diseases

Published online by Cambridge University Press:  04 January 2024

By
David M. Ashley  and
Low Justin T.
Edited by
Farhana Akter ,
Nigel Emptage ,
Florian Engert  and
Mitchel S. Berger
Farhana Akter
Affiliation:
Harvard University, Massachusetts
Nigel Emptage
Affiliation:
University of Oxford
Florian Engert
Affiliation:
Harvard University, Massachusetts
Mitchel S. Berger
Affiliation:
University of California, San Francisco
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Summary

In this chapter we survey the clinical and pathophysiologic principles of gliomas, the primary tumors of the central nervous system. We describe the histologic and clinical features of the main glioma subtypes, including diffuse astrocytic and oligodendroglial gliomas, as well as circumscribed gliomas such as pilocytic astrocytoma and ependymoma. In 2016 the World Health Organization incorporated genetic markers into the diagnostic criteria for gliomas. We discuss the key molecular discoveries that underlie these diagnostic changes, including IDH mutations and 1p/19q codeletion in diffuse gliomas, and the RELA fusion in ependymomas. We provide an overview of the molecular processes and pathways fundamental to gliomagenesis, including disruptions in cell cycle checkpoints, growth factor signaling, telomere maintenance, and epigenetic regulation. Finally, we highlight the physiologic mechanisms of important clinical sequelae of gliomas, including cerebral edema, immune dysregulation, and systemic hypercoagulability.

Type
Chapter
Information
Neuroscience for Neurosurgeons , pp. 184 - 192
Publisher: Cambridge University Press
Print publication year: 2024

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