The Impact of Social Determinants of Health on the Diagnosis of Anaplastic Oligodendroglioma: A Case Report
DOI:
https://doi.org/10.5195/ijms.2025.2900Keywords:
oligodendroglioma, Social Determinants of Health, SDOH in healthcare, Diagnosis, multilingualism, Aphasia, Geriatrics, Bilingual patient, Brain tumor diagnosisAbstract
Background: Anaplastic oligodendroglioma is a rare brain tumor (0.5% of primary brain tumors) usually found in the frontal lobes. Its non-specific symptoms often lead to delayed diagnosis. In bilingual patients, expressive aphasia may be mistaken for limited English proficiency, further delaying care. Recognizing social determinants of health is essential to avoid such delays. The Case: A 75-year-old bilingual woman presented to a routine Cardiology appointment and reported word finding difficulties that worsened over the past 6 months. Five months later at her visit with Geriatrics, she reported more recent issues with expressive aphasia in both English and Spanish and difficulty speaking that started 1-2 years prior. A brain MRI revealed a left frontal lobe mass extending into the genu and body of the corpus callosum. Patient underwent a brain biopsy, which identified an IDH-mutant, 1p/19p co-deleted WHO-III anaplastic oligodendroglioma. Conclusion: Assessing social determinants of health such as language can help physicians diagnose medical conditions presenting with non-specific symptoms. In this case, the diagnosis of expressive aphasia was delayed likely because patient’s symptoms were attributed to limited English proficiency. After careful examination and identifying her symptoms as aphasia in a bilingual patient, a work-up led to the diagnosis of anaplastic oligodendroglioma. Physicians should be aware of the social determinants of health and how they affect individual patients to avoid diagnostic biases, as delays in care such as this one have been shown to result in worsened outcomes, including increased length of hospital stay and mortality.
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