Pediatric Midbrain Tumors: A Benign Subgroup of Brainstem Gliomas

1995 ◽  
Vol 22 (2) ◽  
pp. 65-73 ◽  
Author(s):  
Patricia L. Robertson ◽  
Karin M. Muraszko ◽  
James A. Brunberg ◽  
Richard A. Axtell ◽  
Robert C. Dauser ◽  
...  
Keyword(s):  
Midbrain Tumors

Brain Tectal Tumors: A Flexible Approach

2018 ◽  
Vol 16 (3) ◽  
pp. E95-E100
Author(s):  
Alessandro Perin ◽  
Tommaso Francesco Galbiati ◽  
Cecilia Casali ◽  
Federico Giuseppe Legnani ◽  
Luca Mattei ◽  
...  
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Good Prognosis ◽  
Endoscopic Biopsy ◽  
Third Ventriculostomy ◽  
Histopathological Diagnosis ◽  
Cerebrospinal Fluid Diversion ◽  
Oncological Patients ◽  
Slow Progression ◽  
Benign Histology ◽  
Midbrain Tumors

Abstract BACKGROUND AND IMPORTANCE Mesencephalic tectal gliomas represent a subset of midbrain tumors, which are more frequent in children than in adults. They usually become symptomatic when causing hydrocephalus by occluding the aqueduct. Because of their slow progression, due to their benign histology, they are characterized by a relatively good prognosis, although hydrocephalus might jeopardize patients’ prognosis. Treatment is usually represented by cerebrospinal fluid diversion associated or not with biopsy. CLINICAL PRESENTATION We report 2 illustrative cases of tectal gliomas in adults where endoscopic third ventriculostomy (ETV) and simultaneous endoscopic biopsy were obtained during the same operation by means of a single burr hole with a flexible endoscope. CONCLUSION We recommend using this overlooked neurosurgical tool for such cases, since it allows the surgeon to safely perform an ETV, then judge whether biopsy can be done or not, without harming the patient, and possibly achieving an important piece of information (histopathological diagnosis) to manage this subset of oncological patients.

Dorsally Exophytic Brain Stem Tumors and Midbrain Tumors

1996 ◽  
Vol 24 (5) ◽  
pp. 256-262 ◽  
Author(s):  
Harold J. Hoffman
Keyword(s):  
Brain Stem ◽  
Midbrain Tumors ◽  
Brain Stem Tumors

Indolent dorsal midbrain tumor: new findings based on positron emission tomography

2009 ◽  
Vol 3 (4) ◽  
pp. 270-275 ◽  
Author(s):  
Shigeru Yamaguchi ◽  
Shunsuke Terasaka ◽  
Hiroyuki Kobayashi ◽  
Tohru Shiga ◽  
Reiko Usui ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Obstructive Hydrocephalus ◽  
Emission Tomography ◽  
Biological Behavior ◽  
Low Grade ◽  
Normal Brain ◽  
Biopsy Procedure ◽  
Positron Emission ◽  
New Findings ◽  
Midbrain Tumors

Object Intrinsic tumors arising in the dorsal midbrain cause obstructive hydrocephalus and have an indolent clinical course. Positron emission tomography (PET) with fluorine-18–labeled fluorodeoxyglucose (FDG) and l- [methyl-11C]methionine (MET) was used to evaluate the biological behaviors of dorsal midbrain tumors. Methods The authors report on 4 patients (3 males and 1 female) with dorsal midbrain tumors who presented with obstructive hydrocephalus. A diagnosis was made with MR imaging in each patient. To manage the hydrocephalus, endoscopic third ventriculostomy was performed in all cases. The patients did not undergo any other surgical procedures except endoscopic biopsy procedure, chemotherapy, or radiation therapy. The patients in 3 cases underwent FDG- and MET-PET within 6 months of CSF-diverting procedures, and the patient in 1 case underwent PET 10 years after the procedure. Results After the CSF-diverting procedure, clinical symptoms resolved or improved in all patients. Gliosis or glial proliferation was diagnosed in 1 patient, and possible low-grade glioma in 2 patients. Although all tumors appeared hyperintense on T2-weighted MR images, their appearance on T1-weighted images was variable (iso- and/or hypointense), and partial lesion enhancement was observed on images from 2 patients. On the other hand, the PET features of these lesions were almost identical, and the scans did not show a high uptake of FDG and MET compared with the cortical uptake in a normal brain. The mean tumor tissue/normal tissue ratio of FDG uptake was 0.65, and that of MET was 0.99. Conclusions Positron emission tomography findings suggested that the indolent dorsal midbrain lesion had nontumorous characteristics, thus supporting a good prognosis. Positron emission tomography studies may be more informative and predictive of the biological behavior of dorsal midbrain tumors than a biopsy procedure.

Focal Midbrain Tumors in Children

Neurosurgery ◽  
1993 ◽  
Vol 32 (6) ◽  
pp. 1056 ◽  
Author(s):  
Gilles Guy
Keyword(s):  
Midbrain Tumors

Benign intrinsic tectal “tumors” in children

1991 ◽  
Vol 74 (6) ◽  
pp. 867-871 ◽  
Author(s):  
Paul L. May ◽  
Susan I. Blaser ◽  
Harold J. Hoffman ◽  
Robin P. Humphreys ◽  
Derek C. Harwood-Nash
Keyword(s):  
Mr Imaging ◽  
Intellectual Development ◽  
Content Type ◽  
Radiological Features ◽  
Cystic Component ◽  
Tectal Plate ◽  
Midbrain Tumors ◽  
Csf Diversion ◽  
Serial Examination

✓ A specific group of intrinsic dorsal midbrain tumors was identified in six children by computerized tomography (CT) and magnetic resonance (MR) imaging. Each patient presented with raised intracranial pressure as a result of hydrocephalus due to obstruction of the sylvian aqueduct. No patient had brain-stem signs referable to the tectal tumor initially or subsequently. All six children underwent cerebrospinal fluid (CSF) diversionary procedures. The radiological features were consistent and specific, with all patients showing tectal calcification or primary increased attenuation of the tectal plate on CT scans. In addition, lack of contrast enhancement was noted initially in four patients and eventually in all six patients. In all patients MR imaging showed a focal tectal tumor distorting the colicular plate with no cystic component and increased signal intensity on T2-weighted images. There has been no evidence of progression in these six patients in the follow-up period ranging from 8 months to 17 years (8 months and 2½, 4½, 5½, 8, and 17 years). Diversion of CSF has been the only surgical treatment and no patient underwent deep x-ray therapy. Five patients have had normal intellectual development. In contrast to the majority of previously described periaqueductal and tectal tumors, this group of lesions appeared to be truly benign. The authors suggest that patients presenting with these clinical and radiological features may be managed by CSF diversion, serial examination, and MR imaging.

Focal Midbrain Tumors in Children

Neurosurgery ◽  
1992 ◽  
Vol 31 (2) ◽  
pp. 186???194 ◽  
Author(s):  
William P. Vandertop ◽  
Harold J. Hoffman ◽  
James M. Drake ◽  
Robin P. Humphreys ◽  
James T. Rutka ◽  
...  
Keyword(s):  
Midbrain Tumors

scholarly journals 5-aminolevulinic acid-guided surgery for focal pediatric brainstem gliomas: A preliminary study

2020 ◽  
Vol 11 ◽  
pp. 334
Author(s):  
Jason Labuschagne
Keyword(s):  
Aminolevulinic Acid ◽  
Pediatric Population ◽  
Diffuse Intrinsic Pontine Glioma ◽  
Guided Surgery ◽  
Mri Features ◽  
Pilocytic Astrocytomas ◽  
Total Fluorescence ◽  
Midbrain Tumors ◽  
Solid Fluorescence

Background: There is a growing body of literature supporting the use of 5-aminolevulinic acid (5-ALA) in the pediatric population, however, its use is still considered “off label” in this setting. In this retrospective study, we report our experience using 5-ALA in pediatric patients with focal brainstem gliomas (BSGs). Methods: Patients younger than 16 years presenting with a newly diagnosed BSG that was focal in nature were considered suitable for treatment with 5-ALA-assisted surgery. Exclusion criteria included MRI features suggestive of a diffuse intrinsic pontine glioma. A single dose of 5-ALA was administered preoperatively. Intraoperative fluorescence was recorded as “solid,” “vague,” or “none.” The effectiveness of the fluorescence was graded as “helpful” or “unhelpful.” Results: Eight patients underwent 5-ALA-assisted surgery. There were four tumors located in the pons, two midbrain tumors, and two cervicomedullary tumors. Histological analysis demonstrated three diffuse astrocytomas, three pilocytic astrocytomas, and two anaplastic astrocytomas. Solid fluorescence was found in three of the eight cases, vague fluorescence was found in two cases, and no fluorescence was found in three cases. Fluorescence was useful in 3 (37%) cases. No patients experienced any complications attributable to the administration of the 5-ALA. Conclusion: With a total fluorescence rate of 62.5% but a subjectively assessed “usefulness” rate of only 37.5%, the role of 5-ALA in BSG surgery is limited. Given the toxicological safety, however, of the agent, caution is perhaps needed before dismissing the use of 5-ALA entirely.

scholarly journals Focal Midbrain Tumors in Children

Neurosurgery ◽  
1993 ◽  
Vol 32 (6) ◽  
pp. 1056-1056
Author(s):  
Gilles Guy
Keyword(s):  
Midbrain Tumors

Surgical Approaches to Mesencephalic (Midbrain) Tumors

2020 ◽  
pp. 247-264
Author(s):  
Nir Shimony ◽  
David S. Hersh ◽  
Frederick A. Boop
Keyword(s):  
Surgical Approaches ◽  
Midbrain Tumors
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