[A clinicopathological study of 16 cases with optico-hypothalamic glioma]

Although gliomas of the optic nerve pathways, optico-hypothalamic gliomas, have been considered to be benign neoplasms, some recurrent, malignant gliomas especially at the optic chiasm and hypothalamus have also been reported. It is crucial to know the factors that influence the prognosis of these tumor entities. In order to address this question, we analyzed 16 cases of optico-hypothalamic gliomas treated in our institute with emphasis especially upon the age, location of tumor, histological subtype and treatment modality. Eleven patients younger than 20 years and five older than 20 years were included in this study. In two patients the gliomas were accompanied by neurofibromatosis 1. The male to female ratio was 9:7. Anatomical locations of the tumors were categorized from T1 to T4, and visual symptoms were V0 to V4. Patients with tumors located within the optic nerve, chiasm (T1-3) mainly presented visual symptoms, but those with hypothalamus (T4) showed neuroendocrine signs but not visual ones. Twelve out of 16 cases represented isodense mass lesions on plain CT scans, which were homogenously enhanced by contrast media. Among 15 cases verified pathologically, 10 cases were pilocytic astrocytomas, 4 were astrocytomas and one was anaplastic astrocytoma. The survival rate was measured by Kaplan-Meier method and overall 5-year survival rate was 70.5%. Patients younger than 20 years could survive longer than those older than 20 years (87.5% and 40.0% respectively).(ABSTRACT TRUNCATED AT 250 WORDS)