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Published on: December 13, 2017
Thalamic tumors: clinical presentation
Juan F Martínez-Lage1, Miguel A Pérez-Espejo, Juan A Esteban
1Unit of Pediatric Neurosurgery, Hospital Universitario Virgen de la Arrixaca, 30120 Murcia, Spain. jfmlage@arrixaca.huva.es
Insights
Thalamic tumors (TTs) are rare intracranial neoplasms primarily affecting children and young adults. Common symptoms include raised intracranial pressure, motor deficits, and seizures, though acute presentations can occur.
Area of Science:
- Neuro-oncology
- Pediatric Neurology
Background:
- Thalamic tumors (TTs) represent approximately 1% of intracranial neoplasms.
- These tumors predominantly affect children and young adults, with most childhood cases being low-grade glial tumors.
- Symptom onset is typically more rapid in children than adults.
Purpose of the Study:
- To review the clinical presentation of thalamic tumors in pediatric patients.
- To compare clinical findings in a cohort of 20 children with TTs to existing literature.
Main Methods:
- Retrospective review of clinical data from 20 pediatric patients diagnosed with TTs.
- Comparison of observed clinical features with findings reported in current medical literature.
Main Results:
- Raised intracranial pressure (65%), motor deficits (40%), and seizures (35%) were the most frequent clinical manifestations.
- Acute presentations occurred in 20% of patients; subacute or slow evolution was more common.
- Behavioral/mental changes (25%), involuntary movements (10%), and thalamic syndrome (5%) were less common.
Conclusions:
- Clinical features of pediatric thalamic tumors often relate to mass effect on adjacent structures.
- Symptoms vary, with raised intracranial pressure and neurological deficits being prominent.
- Infants may present with macrocephaly, developmental delay, or visual disturbances.
Introduction:
Thalamic tumors (TTs) account for approximately 1% of all intracranial neoplasms. TTs are seen predominantly in children and young adults. Most childhood neoplasms in this location are of glial lineage, a large proportion being low-grade tumors. The evolution of symptoms before diagnosis is characteristically shorter in children than in adults.
Clinical Presentation:
Clinical features of TTs reflect the pressure of the mass on the cerebrospinal fluid pathways, the pyramidal tracts, the thalamic nuclei and the optic radiations. In this paper, we review the clinical data of 20 children with TTs seen at our hospital and compare the findings with those in the current literature. An acute presentation is not rare and was encountered in 20% of our patients, although most individuals had a subacute or slow evolution. Symptoms and signs of raised intracranial pressure (65%), motor deficits (40%), and seizures (35%), alone or in combination, were the most frequent manifestations of TTs. Behavioral and mental changes are not uncommon in TTs and were found in 25% of our patients. Involuntary movements (10%) and the classic thalamic syndrome (5%) were quite exceptional. Infants and young children with TTs may present with macrocephaly, psychomotor delay, and failing vision or disorders of ocular movements.
