Glioma (Greek glia glue) is a collective term for some brain tumors of the central nervous system . Most often they arise from glial cells , the supporting and nutrient tissue of nerve cells . They usually occur in the brain, but can also occur in the spinal cord and cranial nerves .
The term glioma was first used by Rudolf Virchow in his eighteenth lecture on February 7, 1863 - the first description of glial cells also goes back to him (1858). Virchow's classification has long been the basis for all subsequent classifications. In 1875, Camillo Golgi suggested limiting the term glioma to astrocytic cells.
Harvey Cushing and Percival Bailey , who defined these tumors on the basis of their histological similarities to glial cells in the 1920s, provided essential foundations for today's understanding of gliomas . James Watson Kernohan introduced the concept of biological grading in 1949 and divided gliomas into four possible grades. Klaus-Joachim Zülch merged the terminology from Cushing / Bailey with the graduation concept from Kernohan and thus created the basis for today's WHO classification of gliomas.
Gliomas are named after the glial cell type to which they histologically resemble most - but not necessarily derived from it. This includes:
Degree of malignancy
They can also be classified according to their pathological significance (WHO grade I - IV) according to the WHO classification of tumors of the central nervous system ( e.g. pilocytic astrocytoma WHO grade I, fibrillary astrocytoma WHO grade II, anaplastic astrocytoma WHO grade III, glioblastoma WHO Grade IV).
Gliomas are also differentiated according to whether they are located in the brain stem (pontine, e.g. diffuse intrinsic pons glioma ), above (supratentorial) or under (infratentorial) the tentorium cerebelli (a transverse membrane between the occipital lobe of the cerebrum and the cerebellum ) .
A distinction is made between the following entities :
- Astrocytic tumors (about 60%)
- pilocytic astrocytoma , (WHO grade I)
- subependymal giant cell astrocytoma , (WHO grade I)
- pilomyxoid astrocytoma , (WHO grade II)
- Astrocytoma (variants: fibrillar, protoplasmic, gemistocytic), (WHO grade II)
- pleomorphic xanthoastrocytoma , (WHO grade II)
- anaplastic astrocytoma (WHO grade III)
- Glioblastoma (variants: gliosarcoma , giant cell glioblastoma), (WHO grade IV)
- Oligodendroglial tumors
- Ependymal tumors
- Ependymoma (variants: cellular, papillary, tanycytic, clear cell)
The initial diagnosis corresponds to that of all brain tumors and serves to determine the location, extent and histology of the mass. This is important for neurosurgical intervention planning.
At the beginning there is a medical history ( anamnesis ). The most important diagnostic procedure is magnetic resonance imaging (MRI) of the skull. An alternative method, albeit less suitable for imaging, is computed tomography (CT). The diagnosis is usually confirmed by surgical tissue removal ( biopsy ). In the area of the optic nerve, however, this is associated with a risk of developing or increasing visual disturbances.
In 2008, scientists at the University of California developed a method for using magnetic resonance imaging (MRI) to detect genes typical of the most common types of brain cancer. The method could also help in the early detection of gliomas, because the very slowly growing tumors of this type in young patients often remain inconspicuous and thus undetected for years.
Causes and risks
The exact reason why gliomas develop is not yet known. One also speaks of sporadic - as opposed to hereditary - tumors. As a rule, gliomas are not inheritable (exceptions are e.g. neurofibromatosis , Turcot syndrome or Li-Fraumeni syndrome ).
In 2009, two genome-wide association studies (GWAS) carried out in the USA and Europe led to the discovery of variants on 5 genes which together could explain up to a fifth of all gliomas (publications in Nature Genetics ).
- INTERPHONE study by IARC (2000)
In 2000, the International Agency for Research on Cancer (IARC) initiated an international case-control study (INTERPHONE) to determine a possible risk of developing brain tumors from cell phone use . Among other things, the health hazards associated with cell phone use (high-frequency electromagnetic fields) were examined. Two types of primary tumors were considered, including gliomas because they are the most common and aggressive type of brain tumor.
It was reported, among other things, that the World Health Organization (WHO) classified the intensive use of cell phones as possibly carcinogenic and established, among other things, an increased risk of developing glioma.
The information came from the IARC INTERPHONE study from 2010. The final report was made available in 2011 on the WHO website
In a comparative study with the data from the Interphone study from 2010, US researchers from the National Cancer Institute could not find an increased risk of glioma from cell phone radiation.
SIOP-LGG 2004 is a cooperative, multicenter study for children and adolescents with a low-grade glioma. It has been funded since June 1, 2004 by the German Childhood Cancer Foundation within the framework of the reference center for biometrics . SIOP stands for International Society of Pediatric Oncology and LGG for Low Grade Glioma. The year stands for the start of the study.
The aim of the international, multicenter therapy optimization study SIOP-LGG 2004 is to offer all children and adolescents with a low-grade glioma a comprehensive overall concept that is best possible and adapted therapy based on current knowledge.
The study has been closed since April 2012.
- Martin Allgöwer: Surgery . Springer, 2012, ISBN 978-3-642-11330-7 , pp. 248-251.
- Karl F. Masuhr, Marianne Neumann: Neurology . 6., revised. Edition. Thieme, Stuttgart 2007, ISBN 978-3-13-135946-9 , pp. 319-327: Neuroepithelial tumors (gliomas).
- S2k guideline for gliomas of the German Society for Neurology (DGN). In: AWMF online (as of March 2014)
- S1 guideline for low-grade gliomas in children and adolescents of the Society for Pediatric Oncology and Hematology (GPOH). In: AWMF online (as of 2013)
- S1 guidelines for PET and SPECT examinations of patients with cerebral gliomas using radioactively labeled amino acids from the German Society for Nuclear Medicine (DGN). In: AWMF online (as of 2013)
- Therapy strategy for low-grade gliomas AWMF
- J. Fuchs: Solid tumors in childhood: Basics - Diagnostics - Therapy; with 72 tables; Including DVD with tumor operations . Schattauer Verlag, 2012, ISBN 978-3-7945-2786-1 , p. 157–.
- Glioma - Article on the website of the Clinic and Polyclinic for Neurosurgery of the University Medical Center Greifswald
- Glioma - Article on the website of the University Hospital Halle (Saale)
- Development paths in gliomas - Article on the website of the Saarland University Hospital
- Intracranial gliomas - medical information for patients, website of the German Society for Neurosurgery
- Highly malignant gliomas (brief information) - Article at kinderkrebsinfo.de
- Intracranial gliomas ( memento of the original from March 15, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. - Medical information for patients, website of the German Society for Neurosurgery
- Godehard Koch: Image morphological parameters of preoperative MR tomograms and survival time of patients with malignant gliomas . Dissertation . Fu Berlin , available online: 1. Introduction (pdf) static URL
- Uwe Schlegel, Michael Weller, Manfred Westphal: Neuroonkologie. 2., revised. u. exp. Edition. Thieme, Stuttgart 2003, ISBN 3-13-109062-6 , p. 12.
- Tumors in the head - brain scan detects cancer. In: Spiegel Online. March 25, 2008.
- Primary tumors of the brain and spinal cord. on: krebsgesellschaft.de
- Five genes increase glioma risk. ( Memento of the original of July 14, 2009 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. In: Deutsches Ärzteblatt. July 6, 2009.
- Interphone study reports on mobile phone use and brain cancer risk. IARC, May 17, 2010 (PDF file)
- Technical opinion of the Federal Office for Radiation Protection ( Memento of 7 April 2014 in the Internet Archive ) (BfS) on the results and conclusions of the INTERPHONE study on the risk of brain tumors due to cell phone use - Article at the Federal Office for Radiation Protection
- Christopher Schrader: World Health Organization - Cancer Risk with Intensive Cell Phone Use , Sueddeutsche.de, May 31, 2011.
- Evaluation - WHO sees a possible connection between cell phones and cancer. In: Spiegel Online. June 1, 2011.
- IARC press release 208 of May 31, 2011 (PDF; 257 kB)
- IARC press release 200 on the Interphone study of May 17, 2010 (PDF; 180 kB)
- IARC Report to the Union for International Cancer Control (UICC) on the Interphone Study October 3, 2011 (PDF;)
- interphone.iarc.fr website Interphone Study
- New findings on the glioma risk ( memento of the original from March 3, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. - Information from the Information Center for Mobile Communications, March 2012.
- Institute for Biometry and Clinical Research ( Memento of the original from March 27, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- SIOP-LGG 2004 Multicenter Study for Children and Adolescents with Low Grade Glioma
- SIOP-LGG 2004 in Kinderkrebsinfo ( Memento of the original from March 28, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.