Management Strategy for Adult Patients with Dorsal Midbrain Gliomas

Yeh, David D.; Warnick, Ronald E.; Ernst, Robert

doi:10.1097/00006123-200204000-00009

Cited by 39 publications

(16 citation statements)

References 14 publications

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“…The average age at the time of diagnosis is about 10 years in children, with the majority of cases presenting with raised intracranial pre ss u re secondary to obstruction of the Sylvian aqued u c t 1 4 , with some other cases presented with Parinaud syndro m e 1 5 like the patients observed in our ilustrative cases, although this is also an uncommon f e a t u re. Even before the development of computed t o m o g r a p h y, tectal tumors were an unre c o g n i z e d because of late onset hydro c e p h a l u s 6 , once said that this can be the smallest lesion that can lead to death of the patient.…”

Section: Discussionmentioning

confidence: 99%

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Tectal plate tumors

Lázaro¹,

Landeiro²

2006

Arq. Neuro-Psiquiatr.

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A B S T R A C T -Tectal plate is a rare location for a tumor. Many papers have described diff e rent types of pathology arising in that location including tumors, vascular lesions, inflamatory and infectious processes. In this paper we describe our experience in treating seven patients with tectal plate lesions, with different ages and types of pathology: five patients presented with low grade gliomas, one with lung cancer metastasis and the last presenting with a tectal plate cavernoma. Open surg e ry was perf o rmed in three cases (due to tumor enlargement or need for the exact diagnosis). In the other cases, the treatment of non-comunicating hydrocephalus was the only treatment employed. The prognosis is of course dependent on the underlining pathology. In our series, except in the metastatic tumor case and the cavernoma, the other types of lesion consisted of low grade gliomas. These lesions represent a different type of brain stem tumor sharing a common good prognosis, with a benign behavior. We believe that tectal tumors must be managed case by case. When a patient presents with a benign lesions in the tectal region, treating the main symptom -hydrocephalus -should be the first attempt in management of these lesions.KEY WORDS: brain stem, tectal tumors, brain stem tumors, third ventriculostomy. Tumores da região tectalRESUMO -Tu m o res na região do teto mesencefálico são raros. Vários tipos de lesões como tumores, lesões v a s c u l a res, inflamatórias e infecciosas localizam-se nesta região. Nós revimos o tratamento adotado em sete pacientes com diferentes tipos de lesões tectais: cinco pacientes apresentando gliomas de baixo grau, um paciente com lesão metastática proveniente de câncer de pulmão e um com cavernoma. O tratamento cirúrgico com abordagem direta da lesão foi realizado em três casos (devido ao aumento do volume tumoral ou quando houve necessidade da confirmação diagnóstica). Nos demais casos o tratamento para a hidrocefalia não-comunicante foi o método empregado. O prognóstico dessas lesões é baseado no tipo de patologia em questão. Em nossa série, com exceção do caso de metástase e do paciente com cavern o m a , as demais lesões foram gliomas de baixo grau. Estas lesões re p resentam um subgrupo diferenciado de t u m o res de tronco encefálico, apresentando bom prognóstico e tendo comportamento benigno com sobrevida elevada. Acreditamos que tumores da região tectal devam ser avaliados caso a caso. Na hipótese diagnóstica de uma lesão benigna, o tratamento do principal complexo sindrômico -hidrocefalia não-comunicante -é provavelmente a melhor conduta a ser empregada. PALAVRAS-CHAVE: tronco cerebral, tumores da região tectal, ventriculostomia.

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Section: Discussionmentioning

confidence: 99%

“…In fact this was later discovered as not tru e . Many papers have oriented the presence of this tumor as a special site of low grade gliomas [4][5][6]9,10,18 . These tumors appear to present a better pro g n o s i s given to a slow growing rate and boundaries displacement instead of an infiltrative behaviour.…”

Section: Discussionmentioning

confidence: 99%

Tectal plate tumors

Lázaro¹,

Landeiro²

2006

Arq. Neuro-Psiquiatr.

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“…In tectum gliomas, the low-and high-grade tumors account for 85 and 15 %, respectively [20]. The lowgrade tectum gliomas grow extremely slow, and in the absence of surgery, patients are able to keep in longterm stable via V-P shunt or EVT operation [20,21]. However, the high-grade tectum gliomas grow rapidly and have very short disease course.…”

Section: Reviewmentioning

confidence: 99%

The historical change of brainstem glioma diagnosis and treatment: from imaging to molecular pathology and then molecular imaging

Zhang

Pan

2015

Chin Neurosurg Jl

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Understanding a process from shallow to deep is necessary for controlling and even curing diseases. The history of diagnosis and treatment of brainstem gliomas vividly reflects this process. The development of neuroimaging plays a great role in tumor treatment at different periods, including the period when brainstem gliomas were regarded as an homogenous incurable disease, and currently it is considered as an entity with high heterogeneity. Presently, it is not enough to just rely on the conventional neuroimaging techniques to determine the anatomic location of a tumor and its relationship with normal tissues. The development of molecular genetics and molecular imaging further promotes the progress of individualized and precision diagnosis and treatment in brainstem gliomas. In this paper, we summarize the evolution of brainstem glioma radiological classification mainly focusing on the aspects of imaging and surgical treatment. In the meanwhile, we reviewed the recent progresses in the fields of molecular genetics and molecular imaging.

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“…These neuroanatomical nuances are best viewed on axial and sagittal T2 and non-contrast T1 sequences. Despite these differences, the epicenter of the tumor can be difficult to delineate even on MRI, and there is an overlap between tegmental-aqueductal-periaqueductal-tectal tumors [15,21,37]. Realistically, some ATs are probably included in "tectal glioma" series [4].…”

Section: Pathologymentioning

confidence: 99%

True aqueductal tumors: a unique entity

et al. 2014

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ATs are a rare entities that usually present with obstructive hydrocephalus. Treatment includes primarily cerebrospinal fluid drainage (preferably via an endoscopic third ventriculostomy). Simultaneous endoscopic biopsy may be done in selected cases. Tumor resection should be reserved for growing tumors; the trans-fourth ventricular or trans-choroidal approaches are probably safer than other approaches used to reach the tectal region.

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Management Strategy for Adult Patients with Dorsal Midbrain Gliomas

Cited by 39 publications

References 14 publications

Tectal plate tumors

Tectal plate tumors

The historical change of brainstem glioma diagnosis and treatment: from imaging to molecular pathology and then molecular imaging

True aqueductal tumors: a unique entity

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