Forniceal glioma in children. Clinical article.

Full Abstract

OBJECT: Five to ten percent of pediatric brain tumors are located in the ventricles. Among them, forniceal lesions are rare and their management has not often been described. The aim of this study was to review the clinical, radiological, and histopathological features as well as the feasibility of surgical excision and the outcomes in these patients. METHODS: From a retrospective analysis of 250 cases of supratentorial pediatric glioma, the records of 8 children presenting with forniceal lesions were selected and reviewed. RESULTS: The median age of patients in the cohort was 13.5 years. Presenting features included intracranial hypertension (7 cases), hypothalamic dysfunction (2), and memory dysfunction (3). Complete resection was possible in only 1 case, where the lesion was mainly exophytic; the remaining patients had either a partial resection or biopsy. On histological review, the tumors were confirmed as pilocytic astrocytoma (4 lesions), WHO Grade II astrocytoma (3), and ganglioglioma (1). Postoperatively, working and retrograde memory was normal for all patients, but the authors found a mild alteration in verbal episodic memory in 5 patients. Despite fatigability for 5 patients, academic achievement was normal for all but 2, both of whom had preoperative school difficulties. Additional treatment was required for 5 patients for tumor progression, with a median interval of 19 months from surgery. At a median follow-up duration of 4.9 years, all patients had stable disease. CONCLUSIONS: In this series, forniceal gliomas were found to be low-grade gliomas. They are surgically challenging, and only exophytic lesions may be cured surgically. Due to the high rate of progression of residual disease, adjuvant therapy is recommended for infiltrative tumors, and it yielded excellent results.

Author information

Author/s: Blauwblomme, Thomas (T); Varlet, Pascale (P); Goodden, John R (JR); Cuny, Marie Laure (ML); Piana, Helene (H); Roujeau, Thomas (T); Dirocco, Federico (F); Grill, Jacques (J); Kieffer, Virginie (V); Boddaert, Nathalie (N); Sainte-Rose, Christian (C); Puget, Stéphanie (S);

Affiliation: Departments of Neurosurgery Hôpital Necker Enfants Malades, Université Paris Descartes, Paris.

Journal and publication information

Publication Type: Journal Article

Journal: Journal of neurosurgery. Pediatrics (J Neurosurg Pediatr), published in United States. (Language: eng)

Reference: 2009-Sep; vol 4 (issue 3) : pp 249-53

Dates: Created 2009/09/23; Completed 2009/10/29;

PMID: 19772409, status: MEDLINE (last retrieval date: 10/29/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.