Clinical, radiological, and pathological features of 33 adult unilateral thalamic gliomas

Zhang, Peng; Wang, Xingchao; Ji, Nan; Xie, Jian; Han, Jinsong; Ren, Xiaohui; Song, Guidong; Wu, Ronghan; Zhang, Liwei; Gao, Zhixian

doi:10.1186/s12957-016-0820-x

Cited by 31 publications

(22 citation statements)

References 39 publications

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“…Zhang et al studied the clinical, radiological and pathological features of adult unilateral thalamic gliomas. 13 They reported a mean age of 43.1 years in their cohort, almost similar to Aihara et al, who reported a mean age of 38 years. 8 Both these studies have included grades II, III and IV astrocytomas in their analysis.…”

Section: Discussionsupporting

confidence: 80%

“…The majority of studies so far have analyzed pediatric and adult thalamic gliomas of low and high grades together. Zhang et al studied the clinical, radiological and pathological features of adult unilateral thalamic gliomas . They reported a mean age of 43.1 years in their cohort, almost similar to Aihara et al , who reported a mean age of 38 years .…”

Section: Discussionmentioning

confidence: 60%

“…Since our study was on adult thalamic GBMs, the mean age of patients at presentation was 42 years which is similar to the published literature. 8,13 The duration of symptoms was very short, most common symptoms being headache (65%) and motor deficits.…”

Section: Discussionmentioning

confidence: 99%

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High frequency of H3K27M immunopositivity in adult thalamic glioblastoma

et al. 2019

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Adult thalamic glioblastomas (GBM) are uncommon tumors with limited available molecular data. One of the reported molecular alterations in these tumors is the H3K27M mutation. It has been documented that H3K27M mutation is found in a high proportion of pediatric thalamic gliomas. In this study, we have analyzed the molecular alterations exclusive to adult thalamic GBM. This is a 6 years retrospective study of adult thalamic GBM patients who underwent surgical decompression of the tumor. Clinical data were obtained from the case records. Immunohistochemistry (IHC) was performed on the tumors using antibodies directed against the gene products of R132H mutant isocitrate dehydrogenase 1 (IDH1), alpha‐thalassemia/mental retardation X‐linked (ATRX), p53, H3K27M, H3K27me3, and V600E mutant BRAF. Molecular analyses were carried out to detect other IDH1 and IDH2 mutations, O6‐methylguanine‐DNA‐methyltransferase gene (MGMT) promoter methylation, and epidermal growth factor gene (EGFR) and telomerase reverse transcriptase gene (TERT) promoter mutations. A total of 42 cases of adult thalamic GBM were studied. The mean age of presentation was 42 years with age range of 19–58 years. Male predominance was noted. All the tumors were IDH wild‐type, BRAF (V600E)‐immunonegative and unmethylated for MGMT promoter. H3K27M immunopositivity was noted in 60% of tumors. Of these 33.3% were from older adults above the age of 50 years. Of the H3K27M‐immunopositive cases, ATRX loss of expression was seen in 32%, p53 immunopositivity in 24% and EGFR amplification in 12%. Higher frequency of TERT promoter mutations was noted in H3K27M‐immunonegative cases (58.8%) compared to immunopositive cases (20%). Ours is one of the few studies elucidating the molecular alterations exclusive to adult thalamic GBM. We show a high frequency of H3K27M immunopositivity, suggestive of its mutational status in these tumors, including in older adults.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 60%

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High frequency of H3K27M immunopositivity in adult thalamic glioblastoma

et al. 2019

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“…In large solid lesions, debulking by microsurgery is usually the best, as declared by Zhang et al and Puget et al; in their series, larger resection, whether it was in patients with a low-or high-grade lesions, was associated with better clinical outcome, proving that the extent of resection is an important determinant [3,22]. In large solid lesions planned for microsurgery, MR tractography is usually indicated to assess the feasibility of microsurgery, the designed approach, and the expected morbidity, this was supported by Moshel et al who showed the important role of tractography in choosing and planning the surgical approach through confirming Fig.…”

Section: Discussionmentioning

confidence: 85%

Different strategies in the management of thalamic space-occupying lesions

Fayed¹,

Aziz²,

Eshra³

2020

Egypt J Neurosurg

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Introduction: Thalamic space-occupying lesions (SOL) are considered challenging for microsurgical removal. Unfortunately, the pathological features of lesions occurring in the thalamic region are different with a wide variation in clinical behavior and outcome. Although microsurgery is still the gold standard in the management of these lesions through different approaches, questions remain whether surgery is feasible and safe in these patients and what are the alternatives? It is well known that stereotactic techniques may be favorable especially in cystic, small, multiple lesions and in combination with adjuvant therapy. Transventricular endoscopic approach is also an alternative technique to combine tumor biopsy and treatment of hydrocephalus. Aim of the study: The identification of the different procedures for the management of thalamic SOL in respect to the age of the patient, the clinical condition, and the site of the lesion as well as its extent and pathology. Patients and methods: This prospective study included 35 patients having thalamic lesions with a mean age of 27 years old who were treated with different approaches including microsurgical, stereotactic, and endoscopic approaches. The clinical outcome was assessed as the same, improved, deteriorated, or died in comparison to the initial clinical status, while the radiological control was measured as no gross residual, residual < 10% and residual > 10%. Chi-square test was used to test the association between two categorical variables. Results: Thirty-five patients were included in this study, 20 were males and 15 were females. Eight cases were children, and 27 cases were adults. The most common clinical presentation was contralateral hemiparesis. The most common pathology was pilocytic astrocytoma. Radiological studies showed that the total thalamic type was the most common topographic variant and that 10 cases had hydrocephalus treated with CSF diversion procedures. For the definitive lesion, 2 cases underwent endoscopic biopsy and cystoventriculostomy and 18 cases had stereotactic technique in the form of biopsy, aspiration, and ommaya reservoir application, while 15 cases had microsurgery through different approaches with stereotactic technique preceding surgery in 2 of them. Conclusion: The main factors involved in choosing the appropriate approach included nature of the lesion (solid or cystic, multiplicity), suspected pathological type, and diffusion tensor imaging. Abscesses are best treated with stereotaxy, while non-neoplastic cystic lesions (other than abscesses) related to the ventricles are best treated with endoscopy. For the remaining pathologies, maximum surgical removal is the best management. Best lesion control was provided by microsurgery.

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“…Thalamus; 2 cases in Lt. Thalamus Surgery, RT,and CT T. cort STR in 4 cases; PR in 1 case OS was 2 to 20 months 2 Akiyama et al [ 5 ] 18 3 cases in Rt. thalamus; 2 cases in Lt. thalamus; 13 cases in ventricle, putamen, deep part of frontal lobe Surgery (under endoscope), RT, and CT T. cort GTR in 4 cases; STR in 1 case; PR in 3 cases; biopsy in 10 cases Without data of follow-up 3 Zhang et al [ 4 ] 33 19 cases in Rt. thalamus; 14 cases in Lt. thalamus Surgery in 5 cases; surgery and RT.…”

Section: Introductionmentioning

confidence: 99%

The concept of “Four Walls, Two Poles” in the lesions of the thalamus and ganglion regions: case report and literature review

Yang¹,

Bai²,

Zhang³

et al. 2021

BMC Surg

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Background There are few articles about the surgical techniques of thalamic glioma and the lesions in the basal ganglia area. According to three existing cases and the literature review (Twelve articles were summarized which mainly described the surgical techniques), we discuss the surgical characteristics of lesions of the thalamus and basal ganglia area and summarize the relevant surgical skills. Case presentation Of the three cases, two were thalamic gliomas and one was brain abscess in basal ganglia. According to the three-dimensional concept of the “Four Walls, Two Poles”, lesions of the thalamus and basal ganglia were surgically removed, and the operative effect was analysed by relevant surgical techniques. Surgical resection of the lesions of the thalamus and basal ganglia area according to the three-dimensional concept of the “Four Walls, Two Poles” has achieved good surgical results. Relevant surgical techniques, such as the use of retractors, the use of aspirators, the choice of surgical approaches, and the haemostasis strategy, also played an important role in the operation process. Conclusions In the presented three cases the three-dimensional concept of the “Four Walls, Two Poles” allowed for safe surgical resection of lesions of the thalamus and basal ganglia.

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Clinical, radiological, and pathological features of 33 adult unilateral thalamic gliomas

Cited by 31 publications

References 39 publications

High frequency of H3K27M immunopositivity in adult thalamic glioblastoma

High frequency of H3K27M immunopositivity in adult thalamic glioblastoma

Different strategies in the management of thalamic space-occupying lesions

The concept of “Four Walls, Two Poles” in the lesions of the thalamus and ganglion regions: case report and literature review

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