Author(s): Chawira A.; Foster M.; Pettorini B.; Parks C.; Burn S.; Sinha A.; Giraldi D.; Walkden J.; Brodbelt A.; Chavredakis E.; Jenkinson M.; Mallucci C.
Source: Child’s Nervous System; Oct 2018; vol. 34 (no. 10); p. 2037
Publication Date: Oct 2018
Publication Type(s): Conference Abstract
Available at Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery – from SpringerLink – Medicine
Abstract:OBJECTIVE: Tectal plate gliomas are a rare subset of gliomas which tend to follow a more benign, indolent course compared to other midbrain and brainstem gliomas. This study aims to investigate the clinical outcome of patients with tectal plate gliomas and compare and contrast children with adults. MATERIAL-METHODS: Retrospective case note review of patients with a radiological or histological diagnosis of tectal plate glioma between January 2007 and January 2018. Data were collected on clinical presentation, radiological features, operative management and surveillance. Median follow up 6 years (3 months – 18 years). RESULTS: 50 (14 children, 36 adults) patients were identified. Median age was 19 years (range: 3 months – 62 years). Presenting complaints included hydrocephalus-related symptoms (n=40) and others (n=10). All 14 children had primary ETVs. 5 (35.7%) experienced ETV failure. Of these, 4 had redo ETVs and 1 had a VP shunt. 13 (92.9%) children remain shunt independent. Of the 36 adults, 24 had primary ETV and 8 (33.3%) of these failed; 6 required conversion to a VP shunt and 2 had re-do ETVs. 2 had primary VP shunts with 1 failure requiring conversion to secondary ETV. 10 adults had no intervention. 29 (80.6%) adults remain shunt independent. Overall, 42 (84.0%) patients remain shunt-free. In total, 18 patients were biopsied due to atypical appearances on imaging or radiological progression. 2 (14.2%) children demonstrated radiological progression requiring chemotherapy (n=1) or open surgery (n=1) vs. 8 (22.2%) adults requiring radioactive seeds (n=3), radiotherapy(n=2), debulking (n=2) or chemotherapy (n=1). CONCLUSION: In this mixed adult and paediatric series, 20% demonstrated radiological progression requiring treatment indicating that the natural history and course of these lesions are not entirely benign and that patients should remain under close annual MRI surveillance with consideration of biopsy in the case of atypical appearances on imaging or if radiological progression is observed.