Optic chiasm glioma, electrolyte abnormalities, nonobstructive hydrocephalus and ascites

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Published on: July 5, 2021

A Shuper1, G Horev, S Michovitz

  • 1National Center for Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel.

Medical and Pediatric Oncology
|July 1, 1997
PubMed

Insights

A child with optic chiasm glioma developed ascites and unusual hypernatremia. High cerebrospinal fluid protein may explain these findings and hydrocephalus, suggesting specific OCG characteristics.

Area of Science:

  • Pediatric Oncology
  • Neuro-oncology
  • Neurosurgery

Background:

  • Optic chiasm glioma (OCG) is a rare brain tumor affecting the optic pathways.
  • Management often involves chemotherapy and surgical interventions like ventriculoperitoneal shunts.

Observation:

  • A 4-year-old girl with OCG, hydrocephalus, and a shunt developed significant ascites.
  • Ascitic fluid protein levels correlated with cerebrospinal fluid (CSF) protein levels.
  • Marked hypernatremia (up to 190 mEq/l) occurred without altered mental status.

Findings:

  • Chemotherapy influenced both CSF protein and ascites volume.
  • High CSF protein likely impaired fluid absorption, causing hydrocephalus and ascites.
  • Osmoreceptor dysfunction, possibly due to hypothalamic involvement and high CSF protein, may explain the hypernatremia and preserved mental status.

Implications:

  • This case highlights potential unique clinical manifestations of OCG.
  • Altered fluid dynamics and electrolyte balance warrant consideration in OCG management.
  • Further chemotherapy trials are considered to manage ascites before shunt modification.

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