Summary
Twenty patients (M 11, F 9; ranging from 1–77 years old) with histologically proven glial tumours in the thalamic region, treated from 1979 until 1994 at Kyushu University Hospital were retrospectively reviewed and analysed in order to elucidate their clinical and neuropathological characteristics. The initial common clinical manifestations were those of increased intracranial pressure or motor weakness. The histological diagnosis of the tumour was pilocytic astrocytoma in 2 patients, fibrillary astrocytoma in 7, anaplastic astrocytoma in 7, and glioblastoma multiforme in 4. The initial treatment was surgery alone in 4 patients, surgery followed by radiation therapy in 5, surgery followed by radiation therapy and chemotherapy in 9, and conventional radiation therapy alone in 2 patients. The 3-year overall actuarial survival rate for all patients was 20% but was related to both the histological type and the age of the patients: As a result, the rate was 44% for patients with low-grade astrocytoma compared to 0% for those with high-grade astrocytoma. While 5 out of 11 patients under the age of 25 years at their initial presentation have survived for from 2–16 years after the diagnosis, all patients presenting after the age of 25 years died within 3 years after treatment. Thalamic glial tumours are not a homogeneous group of tumours in terms of clinical behaviour and histopathological features, and the poor overall results, especially in adult tumours, thus emphasise the need for continued research in the treatment of these tumours.
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References
Albright AL, James HE (1985) Neurosurgical staging of midline intra-axial (nuclear) tumour. Cancer 56: 1786–1788
Albright AL, Price RA, Guthkelch AN (1985) Diencephalic gliomas of children: a clinicopathologic study. Cancer 55: 2789–2793
Beks JWF, Bouma GJ, Journée HL (1987) Tumours of the thalamic region. A retrospective study of 27 cases. Acta Neurochir (Wien) 85: 125–127
Bernstein M, Hoffman HJ, Halliday WC, Hendrick EB, Humphreys RP (1984) Thalamic tumors in children. Long-term follow-up and treatment guidelines. J Neurosurg 61: 649–656
Broggi G, Franzini A, Ferraresi S, Sberna M, Servello D, Cajola L, Allegranza A (1988) Cell kinetics and multimodal prognostic evaluation in glial tumors investigated by serial stereotactic biopsy. Acta Neurochir (Wien) 94: 53–56
Cheek WR, Taveras M (1966) Thalamic tumors. J Neurosurg 24: 505–513
Dirks PB, Jay V, Becker LE, Drake JM, Humphreys RP, Hoffman HJ, Rutka JT (1994) Development of anaplastic changes in low-grade astrocytomas of childhood. Neurosurgery 34: 68–78
Drake JM, Joy M, Goldenberg A, Kreindler D (1991) Computer- and robot-assisted resection of thalamic astroycytomas in children. Neurosurgery 29: 27–33
Ehni G (1984) Interhemispheric and percallosal (transcallosal) approach to be cingulate gyri, intraventricular shunt tubes, and certain deeply placed brain lesions. Neurosurgery 14: 99–110
Eifel P, Cassady R, Belli J (1987) Radiation therapy of tumors of the brainstem and midbrain in children: experience of the Joint Center for Radiation Therapy and Children's Hospital Medical Center (1971–1981). Int J Radial Oncol Biol Phys 13: 847–852
Franzini A, Leocata F, Cajola L, Servello D, Allegranza A, Broggi G (1994) Low-grade glial tumors in basal ganglia and thalamus: natural history and biological reappraisal. Neurosurgery 35: 817–821
Greenberger JS, Cassady JR, Levene MB (1977) Radiation therapy of thalamic, midbrain and brain stem gliomas. Radiology 122: 463–468
Greenwood J Jr (1973) Radical surgery of tumors of the thalamus, hypothalamus, and third ventricle area. Surg Neurol 1: 29–33
Grigsby PW, Garcia DM, Simpson JR, Fineberg BB, Schwartz HD (1989) Prognostic factors and results of therapy for adult thalamic and brainstem tumors. Cancer 63: 2124–2129
Grigsby PW, Thomas PR, Schwartz HG, Fineberg BB (1989) Multivariate analysis of prognostic factors in pediatric and adult thalamic and brainstem tumors. Int J Radiat Oncol Biol Phys 16: 649–655
Grigsby PW, Thomas PRM, Schwartz HG, Fineberg B (1987) Irradiation of primary thalamic and brainstem tumors in a pediatric population. A 33-year experience. Cancer 60: 2901–2906
Hirose G, Lombroso CT, Eisenberg H (1975) Thalamic tumors in childhood. Clinical, laboratory and therapeutic considerations. Arch Neurol 32: 740–744
Hoffman HJ, Soloniuk DS, Humphreys RP, Drake JM, Becker LE, De Lima BO, Piatt JH Jr (1993) Management and outcome of low-grade astrocytomas of the midline in children: a retrospective review. Neurosurgery 33: 964–971
Kelly PJ (1989) Stereotactic biopsy and resection of thalamic astrocytomas. Neurosurgery 25: 185–195
Kelly PJ, Alker GJ, Goerss S (1982) Computer-assisted stereotactic laser microsurgery for the treatment of intracranial neoplasms. Neurosurgery 10: 324–331
Kelly PJ, Kall BA, Goerss SJ, Earnest F (1986) Computer-assisted stereotaxic resection of intra-axial brain neoplasms. J Neurosurg 64: 427–439
Krouwer HG, Prados MD (1995) Infiltrative astrocytomas of the thalamus. J Neurosurg 82: 548–557
McGirr SJ, Kelly PJ, Scheithauer BW (1987) Stereotactic resection of juvenile pilocytic astrocytomas of the thalamus and basal ganglia. Neurosurgery 20: 447–452
McKissock W, Paine KWE (1958) Primary tumors of the thalamus. Brain 81: 41–63
Nishio S, Takeshita I, Fujii K, Fukui M (1989) Supratentorial astrocytic tumours of childhood: a clinicopathological study of 41 cases. Acta Neurochir (Wien) 101: 3–8
Nishio S, Takeshita I, Fukui M, Yamashita M, Tateishi J (1988) Anaplastic evolution of childhood optico-hypothalamic pilocytic astrocytoma: report of an autopsy case. Clin Neuropathol 7: 254–258
Partlow GD, del Carpio-O'Donovan R, Melanson D, Peters TM (1992) Bilateral thalamic glioma: review of eight cases with personality change and mental deterioration. AJNR 13: 1225–1230
Souweidane MM, Hoffman HJ (1996) Current treatment of thalamic gliomas in children. J Neurooncol 28: 157–166
Tovi D, Schisano G, Liljeqvist B (1961) Primary tumors of the thalamus. J Neurosurg 18: 730–740
Villarejo F, Amaya C, Diaz CP, Pascual A, Sastre CA, Goyenechea F (1994) Radical surgery of thalamic tumors in children. Childs Nerv Syst 10: 111–114
Wald SL, Fogelson H, McLaurin RL (1982) Cystic thalamic gliomas. Childs Brain 9: 381–393
Woiciechowsky C, Vogel S, Meyer R, Lehmann R (1995) Magnetic resonance imaging of a glioblastoma of the optic chiasm. Case report. J Neurosurg 83: 926–925
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Nishio, S., Morioka, T., Suzuki, S. et al. Thalamic Gliomas: A clinicopathologic analysis of 20 cases with reference to patient age. Acta neurochir 139, 336–342 (1997). https://doi.org/10.1007/BF01808830
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DOI: https://doi.org/10.1007/BF01808830