Surgical Approach to Mesencephalic Tumors

Tanrıkulu, Bahattin; Singh, Gurmit; Özek, M. Memet

doi:10.1007/978-3-319-11274-9_32

Cited by 4 publications

(1 citation statement)

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“…However, tumors with diffuse growth patterns on T2 weighted MRI are not surgically resectable. The prognosis is dismal and patients generally present with headache, nausea, vomiting, double vision secondary to ophthalmoplegia, motor deficits and disequilibrium (25,35). Thalamic gliomas were divided into three different groups as follows: unilateral thalamic gliomas, bilateral thalamic gliomas and thalamopedincular gliomas by Puget et al (28).…”

Section: Discussionmentioning

confidence: 99%

Current clinical practice about pediatric midline gliomas in the scope of molecular era

Tanrıkulu¹,

Özek²

2020

Turkish Neurosurgery

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AIM: To share our clinical experience with surgical and adjuvant treatment strategies followed during the treatment of midline gliomas. MATERIAL and METHODS: Pediatric patients with midline gliomas who underwent surgery in our clinic between March 2016 and November 2019 were included. Tissue samples were obtained through surgical excision, open biopsy, or stereotactic biopsy. All samples were analyzed for ATRX, BRAFV600E, IDH1/2, H3K27M, and H3G34R mutations, EGFR and PGFRA amplifications, and PTEN loss. RESULTS: There were 7 (43.8%) female and 9 (56.2%) male pediatric patients in the study. Eight patients had thalamic, 5 patients had pontine, 2 patients had medulla oblongata and one patient had brachium pontis tumors. Presenting symptoms were headache, disequilibrium, ophthalmoplegia, and panic attack. Eleven tumors showed H3K27M mutation and were diagnosed as diffuse midline gliomas. BRAFV600E, ATRX mutations, PTEN loss, and EGFR amplifications were other molecular alterations detected within tumor samples. Patients with H3K27M mutant tumors had a shorter life span. Five patients were enrolled in an ONC201 trial. CONCLUSION: Although most midline gliomas are not amenable to gross total excision, obtaining tissue samples is mandatory for determining patients' exact diagnoses, tailored treatment plans, and eligibility for clinical trials. Stereotactic biopsy for midline gliomas is a safe and effective method.

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Section: Discussionmentioning

confidence: 99%