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Glioma Diagnosis and Grading

A glioma is a type of brain tumor that develops in the central nervous system and originates from the glial cells. These cells are extremely important as they help maintain the function and health of nerve cells. But if a mutation occurs, it can lead to a brain tumor.

Gliomas can manifest in various locations, but the most common ones occur in the cerebral hemispheres, brainstem, cerebellum and spinal cord. However, the location and size of the glioma all differ from one case to the next.

Glioma by itself isn’t a very common condition, and some types are more common than others. When compared to other cancers, glioma is relatively rare. Nonetheless, it’s very important to stay educated about various kinds of cancers and tumors, which is why we’ve prepared this thorough guide. 

Glioma Diagnosis

Glioma is a serious and complex tumor, which is why medical professionals go through a couple of different tests and examinations before they can be sure the patient is suffering from a glioma.

Physical Exam and Medical History

Performing a physical exam and evaluating the patient’s health history is important because it allows the doctor in charge of the case to make an initial assessment and see whether there are any concerning factors they need to pay attention to.

This examination will include the following:

Checking for symptoms. The most common symptoms related to glioma include headaches, difficulty speaking, personality changes, dizziness, finding it difficult to balance and unexplained weight fluctuations, to name a few.
Previous treatments. If the patient has had cancer in the past and received radiation therapy, they have a greater chance of developing a tumor than those who were never exposed to radiation.
Immune system condition. A weakened immune system leaves the body more susceptible to developing any disease. That is why the doctor will check whether the patient is suffering from a condition or is taking medication that could weaken their immune system.
Family history. Patients who have a family history of brain and spinal cord tumors, or any other cancers, are also more susceptible to developing a glioma.
Genetic conditions. Gliomas by themselves aren’t hereditary, but certain inherited genetic conditions can increase a person’s risk factor for developing glioma. These conditions include neurofibromatosis type 1 and Turcot syndrome.

Neurological Exam

Since gliomas affect the brain, the patient’s neurological condition will be a good indicator of whether a tumor is present.

During a neurological exam, the doctor will check some basic functions, such as the patient’s speech, fine motor skills, coordination and reflexes, muscle strength, simple math skills as well as reasoning and judgment skills.

Computed Tomography (CT) Scan

A CT scan takes images of the patient’s body (their brain and the spinal cord in this case) using X-ray equipment. A computer tomography scan is a useful imaging test when doctors are looking to get detailed images of the blood vessels in the patient’s brain.

A CT scan takes 3D cross-sectional images, which means the doctors can get a very detailed picture of the tumor and see how big it is.

Magnetic Resonance Imaging (MRI)

An MRI takes 3D images of the patient’s brain just like a CT scan, however, it does this by utilizing powerful radiofrequency waves and magnetic forces. There are a couple of different MRIs the doctor may order for the patient, depending on what they’re trying to see.

Different MRIs can show the structure of the brain’s blood vessels, features of the tumor, or how quickly it’s growing.


Imaging tests such as a CT scan and an MRI are used to determine the presence of the tumor, its size and location. However, that isn’t enough to get a good overview of the patient’s condition, which is why doctors need to perform a biopsy.

A biopsy is a procedure during which a surgeon removes a small piece of the tumor, its cells or tissues, and sends it to a pathologist for laboratory testing. This testing will show the tumor’s cellular structure, which will help the pathologist determine whether there are any cancer cells in the sample and what type of glioma the patient is suffering from.

Lumbar Puncture

As glioma can also metastasize in the spinal cord, doctors often perform a specific type of biopsy called a lumbar puncture. During this biopsy, the doctor removes some cerebrospinal fluid via a needle that’s inserted into the spine of the lower back.

A lumbar puncture isn’t always done as a diagnostic procedure, rather only when there is reason to suspect the glioma has spread to the spinal cord.

Molecular Testing

The final test that is used to make a glioma diagnosis is molecular testing, which allows doctors to get a better understanding of the tumor’s molecular and genetic characteristics. Since there are multiple kinds of glioma and all of them have different characteristics, molecular testing is done to pinpoint the type of glioma the patient has.

Thanks to molecular testing, doctors can not only classify the type of glioma but also plan the best treatment, determine the patient’s prognosis and predict their response to therapy.

Glioma Grading

Grading is a term used to describe how the tumor cells look and act when compared to normal cells. The grading is determined by a pathologist during the biopsy and molecular testing, and for glioma, just like many other tumors, the grading system is from 1 to 4.

Grade 1 glioma and grade 2 glioma are considered to be low-grade gliomas. They grow and spread very slowly and can easily be treated with only surgery for grade 2, and surgery with chemotherapy for grade 2. These grades have excellent prognoses and are highly treatable.

Grade 3 glioma and grade 4 glioma are considered to be high-grade gliomas. This means they grow and spread much faster than lower-grade tumors and therefore they attack nearby tissue. These tumors are aggressive and extremely malignant.

For high-grade gliomas, surgery and chemotherapy aren’t enough. Most patients need to receive radiotherapy or even high doses of chemotherapy with a bone marrow transplant. Grade 3 glioma can be cured, but, unfortunately, grade 4 cannot and can only be managed with these treatment options.

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