Analysis of 20 primarily surgically treated chiasmatic/hypothalamic pilocytic astrocytomas

Valdueza, José M.; Lohmann, F.; Dammann, Olaf; Hagel, C; Eckert, Bernd; Freckmann, N.

doi:10.1007/bf01476493

Cited by 26 publications

(16 citation statements)

References 30 publications

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“…Astrocytomas of the optic chiasm and hypothalamus make up 10 % to 15 % of supratentorial tumours in children; males and females are approximately equally affected. One-third of patients have neurofibromatosis type 1 (NF1) [37]. …”

Section: Supratentorial Manifestationsmentioning

confidence: 99%

Manifestations of pilocytic astrocytoma: a pictorial review

et al. 2014

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BackgroundPilocytic astrocytoma can be challenging to diagnose.MethodsIts clinical presentations can differ, directly related to its size and location, and are relatively unreliable. Similarly, imaging findings also vary with the location of the pilocytic astrocytoma.ResultsThis review provides an overview of the different imaging findings regarding pilocytic astrocytomas using both conventional and advanced magnetic resonance imaging sequences according to tumour location; the findings are strongly related to the tumour’s tendency to infiltrate surrounding structures, being able to carry out gross total resection, and finally the prognosis.ConclusionsKnowledge of these imaging manifestations of pilocytic astrocytoma may be helpful to arrive at an accurate diagnosis.Teaching PointsTo recognise the various imaging findings of pilocytic astrocytoma on both conventional and advanced magnetic resonance imaging sequences.To identify the characteristic imaging findings according to tumour location.To discuss the relevant differential diagnoses of pilocytic astrocytoma in each tumour location.

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Section: Supratentorial Manifestationsmentioning

confidence: 99%

Manifestations of pilocytic astrocytoma: a pictorial review

et al. 2014

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“…Studies have shown NF to have a protective effect [13. 19,20], no effect [6], and a deleterious effect [21] on the prognosis of patients with chiasmal astrocytomas. We found no rela tionship between outcome and NF.…”

Section: Discussionmentioning

confidence: 99%

Optic Chiasm Astrocytomas of Childhood

Medlock¹,

Madsen

Barnes

et al. 1997

Pediatr Neurosurg

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We reviewed 61 patients seen from 1975 to 1994 with a biopsy-confirmed optic chiasm astrocytoma or a characteristic clinical and imaging presentation. The mean age at diagnosis was 72 months, including 30 who were less than 5 years old. The mean tumor diameter at presentation was 31 mm among 54 tumors measured. Tumors involved the optic nerve in 41, hypothalamus in 38, optic tract in 15, and optic radiations in 2. Four patients, all with neurofi-bromatosis, received no treatment. Forty patients received conventional radiation therapy at a mean age of 89 months. Chemotherapy was given to 19 children and 7 of these were followed for greater than 1 year. Six of these 7 had progressive disease which required subsequent surgery and/or radiation therapy. Thirty-six patients underwent surgery. We restricted our analysis of outcome to those 38 patients followed for longer than 60 months. Development was normal in 13%, mildly disabled in 53%, severely disabled in 21% and dead in 13%. Children were severely disabled or dead in 47% if younger than 5 years at diagnosis, and 21% if older. There was no endocrine dysfunction in 18% and new endocrine failure was seen in 61%. More posterior tumors did not portend a poorer prognosis. Children less than 5 years old had a poorer prognosis. Neurofibromatosis did not have a marked effect on outcome. Intracranial hypertension was an indicator of a poor prognosis. No specific treatment modality was clearly superior in terms of long-term survival or improvement in quality of life.

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“…On CT, the hypothalamic-chiasmatic astrocytoma mass is hypointense or isointense with enhancement. 96,97 On MR imaging, a hypothalamic-chiasmatic astrocytoma has classically T2WI hyperintense and T1WI hypointense to isointense signal and mild to avid enhancement. 90 There is usually …”

Section: Hypothalamic-chiasmatic Gliomamentioning

confidence: 99%