Thalamic glioma explained

Thalamic glioma
Specialty:Neuro-oncology, neurosurgery
Causes:Unknown
Prevention:Unknown
Treatment:Watchful waiting, radiation therapy, chemotherapy, resection
Prognosis:Two year survival rate 19.7% (adults), pediatric five year survival rate 15-25% (high grade astrocytoma) or 40% (low grade astroyctoma)

Thalamic gliomas are very rare, deep-seated, generally high-grade glial neoplasms that form in the thalamus, representing 1–5% of all pediatric brain tumors. Because of their difficult to reach position, they are a unique and difficult challenge for neuro-oncologists and neurosurgeons.

Diagnosis

Thalamic gliomas are most often discovered on magnetic resonance imaging following symptoms, with the most common presenting symptom being motor deficit. While a definitive diagnosis of the neoplasm cannot be made without a biopsy of the tumor, biopsies have historically been avoided due to the extreme sensitivity of the region.

Bithalamic glioma

A notable variant of thalamic gliomas are bithalamic gliomas. Bithalamic gliomas cross the interthalamic adhesion and occupy space in both thalami. These have poorer outcomes than unilateral thalamic gliomas.[1]

Treatment

Unless a thalamic glioma shows aggressive behavior, they are often treated with a "watch and wait" approach until signs of growth occur.[2] Thalamic gliomas can be treated with radiotherapy, chemotherapy, and/or resection.[3]

Resection

Thalamic gliomas are among the most difficult challenges a neurosurgeon faces today. Historically, thalamic gliomas were considered inoperable.[4] Advances in neurosurgical technology have opened up the thalamic area to resection, but conservative approaches remain popular.[5] Microsurgical approaches are well suited for thalamic gliomas.[6]

Prognosis

Thalamic gliomas have a poor prognosis. In adult patients, the overall two-year survival rate is 19.7%, with low grade tumors holding a two-year survival rate of 31.0% and high-grade tumors holding a two-year survival rate of 16.5%.[7] In pedtiatric patients, low-grade astrocytomas held a five-year survival rate of 40% while high-grade astrocyte tumors held a five-year survival rate that varies between 15% and 25%.[8] Strangely, pediatric thalamic oligodendrogliomas appear to have a far worse prognosis than thalamic astrocytomas, with a three-year survival rate of 14% in one series.

Higher Karnovsky performance status and CSF diversion[9] are good prognostic markers in cases that match the criteria for glioblastoma.

While the H3K27m mutation that is the distinct marker of a diffuse midline glioma is generally a very poor prognostic factor, it is unusually associated with slightly higher rates of survival in adult thalalmic glioma patients.[10]

Pathology

Thalamic gliomas are often but not exclusively diffuse midline gliomas; other varieties of glial tumor can develop in this region.

Prominent patients

References

  1. Niu . Xiaodong . Wang . Tianwei . Yang . Yuan . Gan . Youjun . Li . Jiaoming . Liu . Yanhui . Mao . Qing . 2018-02-02 . Prognostic Factors for the Survival Outcome of Bilateral Thalamic Glioma: An Integrated Survival Analysis . . 110 . e222–e230 . 10.1016/j.wneu.2017.10.132 . 29102752 . 1878-8750. free .
  2. Ryall . Scott . Tabori . Uri . Hawkins . Cynthia . 2020-03-12 . Pediatric low-grade glioma in the era of molecular diagnostics . Acta Neuropathologica Communications . en . 8 . 1 . 30 . 10.1186/s40478-020-00902-z . free . 2051-5960 . 7066826 . 32164789.
  3. Dixit . Karan . Schulte . Jessica . Kumthekar . Priya . Liu . Benjamin . Jovanovic . Borko . Helenowski . Irene . Raizer . Jeffrey . 2016-04-05 . Clinical Course of Adult Patients with Thalamic Gliomas (P6.297) . Neurology . en . 86 . 16_supplement . 10.1212/WNL.86.16_supplement.P6.297 . 0028-3878.
  4. Web site: Thalamic Glioma Overview . 2024-04-30 . . en.
  5. Serra . Carlo . Türe . Hatice . Yaltırık . Cumhur Kaan . Harput . Mehmet Volkan . Türe . Uğur . 2020-10-02 . Microneurosurgical removal of thalamic lesions: surgical results and considerations from a large, single-surgeon consecutive series . Journal of Neurosurgery . EN . 135 . 2 . 458–468 . 10.3171/2020.6.JNS20524 . 33007756 . 1933-0693.
  6. Wu . Biwu . Tang . Chao . Wang . Yang . Li . Zhiqi . Hu . Shukun . Hua . Wei . Li . Wengang . Huang . Shan . Ma . Junfeng . Zhang . Yi . March 2018 . High-grade thalamic gliomas: Microsurgical treatment and prognosis analysis . Journal of Clinical Neuroscience . 49 . 56–61 . 10.1016/j.jocn.2017.12.008 . 29248381 . 0967-5868.
  7. Palmisciano . Paolo . El Ahmadieh . Tarek Y. . Haider . Ali S. . Bin Alamer . Othman . Robertson . Faith C. . Plitt . Aaron R. . Aoun . Salah G. . Yu . Kenny . Cohen-Gadol . Aaron . Moss . Nelson S. . Patel . Toral R. . Sawaya . Raymond . 2021-11-19 . Thalamic gliomas in adults: a systematic review of clinical characteristics, treatment strategies, and survival outcomes . Journal of Neuro-Oncology . en . 155 . 3 . 215–224 . 10.1007/s11060-021-03898-1 . 34797525 . 0167-594X.
  8. Gupta . Avneesh . Shaller . Nathan . McFadden . Kathryn A. . 2017-10-01 . Pediatric Thalamic Gliomas: An Updated Review . Archives of Pathology & Laboratory Medicine . 141 . 10 . 1316–1323 . 10.5858/arpa.2017-0249-ra . 28968159 . 0003-9985. free .
  9. Esquenazi . Yoshua . Moussazadeh . Nelson . Link . Thomas W . Hovinga . Koos E . Reiner . Anne S . DiStefano . Natalie M . Brennan . Cameron . Gutin . Philip . Tabar . Viviane . July 2018 . Thalamic Glioblastoma: Clinical Presentation, Management Strategies, and Outcomes . Neurosurgery . en . 83 . 1 . 76–85 . 10.1093/neuros/nyx349 . 0148-396X . 6939410 . 28973417.
  10. Grimaldi . Stéphan . Harlay . Vincent . Appay . Romain . Bequet . Céline . Petrirena . Grégorio . Campello . Chantal . Barrié . Maryline . Autran . Didier . Boissonneau . Sébastien . Graillon . Thomas . Figarella-Branger . Dominique . Nanni . Isabelle . Chinot . Olivier . Tabouret . Emeline . 2022-02-01 . Adult H3K27M mutated thalamic glioma patients display a better prognosis than unmutated patients . Journal of Neuro-Oncology . en . 156 . 3 . 615–623 . 10.1007/s11060-022-03943-7 . 1573-7373.
  11. Book: Cosgrove, Stuart . Detroit 67: The Year That Changed Soul . 2016-10-02 . . 978-0-85790-334-1 . Revised . Edinburgh.

External links

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Thalamic glioma".

Except where otherwise indicated, Everything.Explained.Today is © Copyright 2009-2024, A B Cryer, All Rights Reserved. Cookie policy.