Radical surgery of thalamic tumors in children

Abstract

The authors review eight cases of thalamic tumors in children. Radical surgery was performed in seven cases. All cases were diagnosed by computed tomographic scanning, and histological diagnosis showed seven benign astrocytomas and one malignant astrocytoma. All patients are still alive. The treatment of these tumors is discussed.

Surgical approach to thalamic tumors

“…They can occur in all age groups; however, a preponderance of children and adolescents has been reported by several authors [2,5,7,12,17,18,19,23,26,29,30,33]. Overall, the male-tofemale ratio is almost equal [33].…”

“…Various transcortical transventricular approaches have been described for thalamic tumor resection, such as a frontal transventricular approach [3,7] for superior anteriorly located tumors, occipital [7] or parieto-occipital transventricular approaches [25] for posteriorly located tumors, and a transcortical transtemporal approach between T1 and T2 [29] for ventral posteriorly located tumors (Fig. 4).…”

“…Various surgical approaches have been described for resection of the thalamic tumors such as a transcortical transventricular approach, an anterior interhemispheric transcallosal approach [3,7,29,32], a contralateral infratentorial supracerebellar approach [25], a posterior interhemispheric parasplenial approach [33], and a transsylvian transinsular approach. Each of these approaches has its own indications and risk of complications.…”

“…Thalamic tumors comprise 1-5% of all brain tumors [2,5,7,12,17,26,29,33]. They can occur in all age groups; however, a preponderance of children and adolescents has been reported by several authors [2,5,7,12,17,18,19,23,26,29,30,33].…”

Gross Total Removal of Gliomas in the Pulvinar and Correlative Microsurgical Anatomy.

“…Radical or maximum removal of thalamic gliomas has been recently reported using an operating microscope with acceptable morbidity via several routes. 1,2,31,35,38,39,43) Circumscribed and histologically benign lesions may be considered favorable for microsurgical removal. Tumors of the pulvinar, in particular, tend to grow exophytically into the lateral and third ventricles, and sometimes extend posteriorly or inferiorly into the quadrigeminal and ambient cisterns (ipsilateral half of the posterior incisural space).…”