Author(s): Giraldi D.; Walkden J.; Brodbelt A.; Chavredakis E.; Jenkinson D.; Malucci C.
Source: British Journal of Neurosurgery; 2018; vol. 32 (no. 1); p. 113
Publication Date: 2018
Publication Type(s): Conference Abstract
Abstract:Objectives: Tectal gliomas are a rare subset gliomas accounting for less than 5% of brainstem tumours in children and 8% in adults. Historically, it has been reported that tectal gliomas are more likely to follow a benign, indolent course than brainstem gliomas. We investigated the clinical history, radiological surveillance and operative management of tectal plate glioma in a large adult series. Methods: All neuroradiology reports available at our institution from January 2007 to March 2015 were searched using ‘tectal plate’, ‘tectal lesion’ and ‘tectal glioma’ as keywords. Clinical details (history, age, clinical course, neuropathology and operative inter-ventions) were identified from case notes. Results: We identified 39 suspected low grade tectal plate gliomas of which 12 had confirmed neuropathology. 7 tectal plate lipomas and 3 non glial tumours involving the tectal plate were identified. Of the 12 patients with proven histology the average age at diagnosis was 24 years with all but 3 presenting with hydrocephalus. Neuropathology confirmed 9 grade II astrocytoma and 3 pilocytic astrocytomas. 3 patients subsequently received radiotherapy and 2 received chemoradiotherapy for radiological progression since diagnosis. All patients remain alive with a median follow up of 9.5 years. Conclusions: The natural history and course of tectal plate glioma is therefore not entirely benign and patients should remain under close annual MRI surveillance with consideration of biopsy if radiological progression is observed.