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We describe a case presenting as weight loss without neurological signs, caused by a thalamic astrocytoma. Case report A 43 year old woman had noted a 24 kg weight loss in a year. In 1978 she developed non-specific diarrhoea with malaise and depression. She had lived in Thailand from 1972-5 and moved to Sweden two years before presentation in 1982, her weight having dropped from 60 kg to 36 kg. She had also noted brief and infrequent episodes of diplopia, although a neurologist and ophthalmologist could find no abnormality. She was extensively investigated with numerous normal investigations, including routine haematology and biochemical tests, plasma protein electrophoresis, autoantibodies, rheumatoid factor, Australia antigen, vitamin B12, thyroid function tests, diurnal cortisols, barium enema, small bowel enema, chest radiograph, intravenous urogram and gastroscopy. Stool examinations for bacteria and parasites were also normal. The serum folate was raised at 34