Glioma, Astrositoma ve Oligodendroglioma
Özet
Gliomlar en sık görülen primer santral sinir sistemi (SSS) tümörleridir. Gliomların yıllık insidansı her 100.000 kişide 6-7 vaka olarak bildirilmiştir. Hastalarda; baş ağrısı, baş dönmesi, denge kaybı, nöbet, nörolojik defisitler, bilinç bozukluğu, görme kusurları, konuşma bozukluğu ve his kusurları gibi şikayetler görülür. Glial tümörlerin tanısında ve takibinde manyetik rezonans görüntüleme (MRI) altın standarttır. Diffüzyon- perfüzyon MR ve MR-spektroskopi gibi özel MR teknikleriyle, tanı ve takipte daha detaylı bilgiler elde edilebilir. MRI’nın yanı sıra aminoasit PET CT de hastalık nüksünü ve progresyonunu göstermek için kullanılabilir. Glial tümörlerin tedavisinde maksimal güvenli rezeksiyon esastır. Dünya Sağlık Örgütü (WHO) 2021 SSS tümörleri sınıflandırmasına göre immunohistokimyasal (IHC) ve moleküler inceleme ile tanı koyulur. Glial tümörler, cerrahi rezeksiyon, radyoterapi ve/veya kemoterapi gibi tedavi yöntemleri kllanılarak tedavi edilir. Tedavi edilen hastalarda, özellikle kötü prognostik özelliklere sahip tümörü olanlarda, hastalığın nüks oranları yüksektir. Bu sebeple hastalık nüksünün veya progresyonunun erken tanısı ve tedavi edilmesi açısından takip son derece önemlidir. Beyin MRI ve nörolojik fizik muayene ile takip sıklığı ve süresi, hasta ve hastalık özelliklerine göre belirlenmelidir.
Gliomas represent the most prevalent primary central nervous system (CNS) tumors. The annual incidence of gliomas has been documented as 6-7 cases per 100,000 individuals. Pursuant to the patient's complaints, the following symptoms have been documented: headaches, dizziness, loss of balance, seizures, neurological deficits, impaired consciousness, visual defects, speech impairment, and sensory defects. Magnetic resonance imaging (MRI) is the gold standard in the diagnosis and follow-up of glial tumors. Special MR techniques such as diffusion-perfusion MR and MR-spectroscopy can provide more detailed information for diagnosis and follow-up. In addition to MRI, amino acid PET CT has been demonstrated to be a useful modality in demonstrating disease recurrence and progression. Maximal safe resection is essential in the treatment of glial tumors. According to the World Health Organization (WHO) 2021 classification of central nervous system (CNS) tumors, diagnosis is made by immunohistochemical (IHC) and molecular examination. Glial tumors are treated by surgical resection, radiotherapy and/or chemotherapy. Recurrence rates are high in treated patients, especially in those with tumors with poor prognostic features. Therefore, follow-up is extremely important for early diagnosis and treatment of disease recurrence or progression. The frequency and duration of follow-up with brain MRI and neurological physical examination should be determined according to patient and disease characteristics.
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