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Gliomas

Last reviewed: 14 Sep 2025
Last updated: 23 Apr 2025

Summary

Definição

História e exame físico

Principais fatores diagnósticos

  • presence of risk factors
Detalhes completos

Outros fatores diagnósticos

  • altered mental status
  • headache
  • nausea and/or vomiting
  • gait abnormality
  • ataxia
  • weakness
  • seizures
  • visual disturbances
  • speech deficit
  • aphasia/dysphasia
  • sensory deficit
  • motor weakness
  • visual change
  • cranial nerve palsy
  • papilloedema
  • personality change/emotional lability
Detalhes completos

Fatores de risco

  • white ancestry
  • male sex
  • neurofibromatosis type 1
  • tuberous sclerosis complex
  • Li-Fraumeni syndrome
  • Turcot's cancer syndrome
  • ionising radiation
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • MRI head
  • ophthalmological evaluation; visual field testing
  • CT head
  • brain MR spectroscopy
  • brain perfusion MRI
  • histopathology
  • molecular analyses
Detalhes completos

Investigações a serem consideradas

  • pituitary hormones tests
  • diffusion tensor imaging (DTI)
Detalhes completos

Novos exames

  • 2-hydroxyglutarate-targeted magnetic resonance spectroscopy

Algoritmo de tratamento

Inicial

elevated intracranial pressure or vasogenic oedema

AGUDA

circumscribed glioma: pilocytic/pilomyxoid astrocytoma (World Health Organization [WHO] grade 1)

circumscribed glioma: subependymal giant cell astrocytoma (WHO grade 1)

circumscribed glioma: pleomorphic xanthoastrocytoma (WHO grade 2)

diffuse infiltrating glioma: grade 2

diffuse infiltrating glioma: grades 3 and 4

diffuse midline glioma, H3 K27M-altered

CONTÍNUA

recurrent circumscribed glioma

progressive diffuse infiltrating glioma

Colaboradores

Autores

L. Nicolas Gonzalez Castro, MD, PhD

Instructor in Neurology

Center for Neuro-Oncology

Dana-Farber Cancer Institute and Brigham and Women's Hospital

Harvard Medical School

Boston

MA

Declarações

LNGC has received consulting fees from Elsevier, Oakstone Publishing, and Teladoc. LNGC has received research funding from Merck & Co. (to Dana-Farber Cancer Institute). LNGC is an author of a number of references cited in this topic.

Agradecimentos

Dr L. Nicolas Gonzalez Castro would like to gratefully acknowledge Dr Timothy C. Ryken, Dr Linton T. Evans, Dr Manmeet S. Ahluwalia, Dr Susan Chang, and Dr Karine Michaud, previous contributors to this topic.

Declarações

TCR is an author of a number of references cited in this topic. MSA has acted as a consultant for Elekta, Incyte, AstraZeneca, Novocure, Caris Life Sciences, Bristol-Myers Squibb, Monteris Medical, AbbVie, MRI Solutions, Elsevier, and Prime oncology. MSA has received clinical trial investigations grants from Tracon, Bristol-Myers Squibb, AstraZeneca, Novartis, and Novocure. SC has received research support from Agios, Novartis, Quest, Roche, and Schering Plough. KM and LTE declare that they have no competing interests.

Revisores

David A. Reardon, MD

Associate Professor

The Preston Robert Tisch Brain Tumor Center

Duke University Medical Center

Durham

NC

Declarações

DAR declares that he has no competing interests.

Créditos aos pareceristas

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Referências

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Principais artigos

Louis DN, Perry A, Wesseling P, et al. The 2021 WHO classification of tumors of the central nervous system: a summary. Neuro Oncol. 2021 Aug 2;23(8):1231-51.Texto completo  Resumo

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: central nervous system cancers [internet publication].Texto completo

Weller M, van den Bent M, Preusser M, et al. EANO guidelines on the diagnosis and treatment of diffuse gliomas of adulthood. Nat Rev Clin Oncol. 2021 Mar;18(3):170-86.Texto completo  Resumo

Liau LM. Guidelines for newly diagnosed glioblastoma. J Neurooncol. 2008 Sept;89(3).Texto completo

American Association of Neurological Surgeons; Congress of Neurological Surgeons. Updated AANS/CNS guidelines for progressive glioblastoma patients. Jun 2022 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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  • Diretrizes

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