Malignant Glioma

This chapter provides a comprehensive overview of malignant gliomasMalignant glioma, the most common primary brain tumorPrimary brain tumor in adults. These tumors are varied in their cellular origin, geneticGenetics profile, and morphologyMorphology under the microscopeMicroscope, but together they share some of the most dismal prognoses of all neoplasmsNeoplasm in the body. Although there is currently no cure for malignant gliomaMalignant glioma, persistent efforts to improve outcomes in patients with these tumors have led to modest increases in survivalSurvival, and researchers worldwide continue to strive toward a deeper understanding of the factors that influence gliomaGliomas development and response to treatment. In addition to well-established epidemiology, clinical manifestations, and common histopathologic and radiologic features of malignant gliomasMalignant glioma, this section considers recent advances in molecular biologyMolecular biology that have led to a more nuanced understanding of the geneticGenetics changes that characterize the different types of malignant gliomaMalignant glioma, as well as their implications for treatment. Beyond the traditional classification of malignant gliomasMalignant glioma based on histopathological features, this chapter incorporates the World Health Organization’sWorld Health Organization (WHO) 2016 criteria for the classification of brain tumorsBrain tumor, with special focus on disease-defining geneticGenetics alterations and newly established subcategories of malignant gliomaMalignant glioma that were previously unidentifiable based on microscopic examination alone. Traditional therapeutic modalities that form the cornerstone of treatment for malignant gliomaMalignant glioma, such as aggressive surgical resectionSurgical resection followed by adjuvantAdjuvant chemotherapyChemotherapy and radiation therapyRadiation therapy, and the studies that support their efficacy are reviewed in detail. This provides a foundation for additional discussion of novel therapeutic methods such as immunotherapyImmunotherapy and convection-enhanced deliveryConvection-enhanced delivery (CED), as well as new techniques for enhancing extent of resectionExtent of resection (EOR) such as fluorescence-guided surgeryFluorescence-guided surgery.