Diencephalic gliomas of children. A clinicopathologic study

The authors reviewed the clinical information and pathology specimens from 29 children with diencephalic gliomas to determine whether any clinical or histopathologic feature correlated with prognosis. The median survival time for the entire group was 3.96 years. No symptom or sign at the time of diagnosis correlated with outcome. The tumors consisted of 25 astrocytomas or mixed gliomas and 4 malignant astrocytomas-mixed gliomas. Median survival time of the 25 children with astrocytomas-mixed gliomas was 4.8 years, compared with 0.5 years for the 4 children with malignant tumors. The tumor histology was relatively uniform: most tumors were moderately cellular astrocytomas with pleomorphism and hyperchromatism but without mitoses, hemorrhage, or necrosis. High cell density and the presence of mitoses were the two histologic features significantly associated with poor prognosis; no child with mitosis survived longer than 14 months.