Tectal gliomas: Natural history of an indolent lesion in pediatric patients

Daniel C. Bowers, Christos Georgiades, Leslie J. Aronson, Benjamin S. Carson, Jon D. Weingart, Moody D. Wharam, Elias R. Melhem, Peter C. Burger, Kenneth J. Cohen

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

The mesencephalic tectal glioma is a distinctive form of brain stem glioma with an unusually benign clinical course. Periaqueductal location, lack of contrast enhancement, and long periods of stability are classic features. The clinical management of these lesions, especially at the time of radiographic enlargement varies widely in the published literature. It is unclear whether these progressive lesions need to be treated. Accordingly, clinical and radiologic features of 7 patients were reviewed, with attention to the clinical course of the disease after radiologic enlargement. The age at diagnosis ranged from 3.3 to 16.6 years. Six of 7 had MRI tumor enlargement beginning 0.3-5.7 years after initial diagnosis. One of these 6 patients had radiographic progression coupled with a new clinical symptom which was treated with stereotactic radiation therapy. The remaining 5 patients with MRI progression and normal neurological exams were not treated and remain free of new neurologic deficits 1.8-6.9 years after the first radiographic tumor enlargement. The results suggest that pediatric tectal gliomas are a very low-grade lesion. Conservative management in the absence of new clinical symptoms could be argued, reserving radiotherapy or chemotherapy for clinical progression. Copyright (C) 2000 S. Karger AG, Basel.

Original languageEnglish (US)
Pages (from-to)24-29
Number of pages6
JournalPediatric Neurosurgery
Volume32
Issue number1
DOIs
StatePublished - Jan 2000

Keywords

  • Low-grade glioma
  • Tectal glioma
  • Tumor progression

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Clinical Neurology

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    Bowers, D. C., Georgiades, C., Aronson, L. J., Carson, B. S., Weingart, J. D., Wharam, M. D., Melhem, E. R., Burger, P. C., & Cohen, K. J. (2000). Tectal gliomas: Natural history of an indolent lesion in pediatric patients. Pediatric Neurosurgery, 32(1), 24-29. https://doi.org/10.1159/000028893