Analysis of 20 primarily surgically treated chiasmatic/hypothalamic pilocytic astrocytomas

TY - JOUR

T1 - Analysis of 20 primarily surgically treated chiasmatic/hypothalamic pilocytic astrocytomas

AU - Valdueza, J M

AU - Lohmann, F

AU - Dammann, O

AU - Hagel, C

AU - Eckert, B

AU - Freckmann, N

PY - 1994/1/1

Y1 - 1994/1/1

N2 - The authors review the therapeutic results of 20 patients (aged 12 months to 30 years, mean age 9 years) with benign pilocytic astrocytoma of the chiasmatic/hypothalamic region, seen at the University Hospital Hamburg-Eppendorf between February 1980 and April 1993. Six patients suffered from neurofibromatosis 1 (NF-1). The patients were divided into two subgroups relative to tumour extension and growth patterns, as revealed by CT scans and/or MR imaging. Fourteen patients revealed a large globular suprasellar tumour extending into the hypothalamus and/or the anterior third ventricle (group A). A suprasellar tumour with optic tract involvement could be identified in six cases (group B). Subtotal (70-90%) resection was achieved in ten tumours (50%), the majority of which were of the large globular type. There were no deaths. Postoperative morbidity was comprised of visual and endocrine impairment in four patients and right hemiparesis and dysphasia in one patient. Radiation therapy was given in nine cases (45%). Three tumours (38%) were reduced in size by irradiation. Tumour progression was seen in seven patients (35%). The presence of young age and NF-1 were predictors of progressive disease in our series. Growth capacity was not related to the extent of cytoreductive surgery.

AB - The authors review the therapeutic results of 20 patients (aged 12 months to 30 years, mean age 9 years) with benign pilocytic astrocytoma of the chiasmatic/hypothalamic region, seen at the University Hospital Hamburg-Eppendorf between February 1980 and April 1993. Six patients suffered from neurofibromatosis 1 (NF-1). The patients were divided into two subgroups relative to tumour extension and growth patterns, as revealed by CT scans and/or MR imaging. Fourteen patients revealed a large globular suprasellar tumour extending into the hypothalamus and/or the anterior third ventricle (group A). A suprasellar tumour with optic tract involvement could be identified in six cases (group B). Subtotal (70-90%) resection was achieved in ten tumours (50%), the majority of which were of the large globular type. There were no deaths. Postoperative morbidity was comprised of visual and endocrine impairment in four patients and right hemiparesis and dysphasia in one patient. Radiation therapy was given in nine cases (45%). Three tumours (38%) were reduced in size by irradiation. Tumour progression was seen in seven patients (35%). The presence of young age and NF-1 were predictors of progressive disease in our series. Growth capacity was not related to the extent of cytoreductive surgery.

KW - Adolescent

KW - Adult

KW - Astrocytoma

KW - Biopsy

KW - Child

KW - Child, Preschool

KW - Combined Modality Therapy

KW - Cranial Nerve Neoplasms

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Hypothalamic Neoplasms

KW - Infant

KW - Magnetic Resonance Imaging

KW - Male

KW - Neoplasm Staging

KW - Neurofibromin 1

KW - Optic Chiasm

KW - Postoperative Complications

KW - Proteins

KW - Tomography, X-Ray Computed

KW - Tumor Markers, Biological

M3 - SCORING: Journal article

C2 - 8154322

VL - 126

SP - 44

EP - 50

JO - ACTA NEUROCHIR

JF - ACTA NEUROCHIR

SN - 0001-6268

IS - 1

ER -