title: Pediatric tectal plate gliomas: a review of clinical outcomes, endocrinopathies, and neuropsychological sequelae.
abstract: Pediatric tectal plate gliomas are indolent slow-growing gliomas that often present with increased intracranial pressure or incidentally on routine brain imaging. We investigated clinical outcomes, endocrinopathies, and neuropsychological sequelae associated with tectal plate gliomas. Twenty-six patients with tectal plate glioma were identified in a 20-year retrospective review. Clinical outcomes, treatments, endocrine function, neuropsychological testing outcomes and radiographic imaging were reviewed for possible signs correlating with tumor progression. Among 26 patients, 19 presented with signs or symptoms of increased intracranial pressure (73 %) versus an incidental finding in 7 (27 %). Median follow-up was 46 months (range 8-143 months). Six of 26 (23 %) experienced progressive disease after diagnosis. Five of 26 (19 %) required more than one surgical procedure due to failure of initial endoscopic third ventriculostomy. Seven of 26 had history of endocrine dysfunction, of which, five presented with endocrine dysfunction (precocious puberty or short stature), 1 developed menstrual irregularities after surgical intervention and 1 had preexisting pan hypopituitarism. Of 12 patients with available neuropsychological testing, eleven had at least one indicator of executive functioning in the low-average to impaired range. While tectal plate gliomas have been considered indolent tumors that are rarely progressive, 23 % of patients in our cohort experienced disease progression and required further therapy. Neurocognitive deficits may occur, while endocrine deficiency is uncommon. Regular multidisciplinary oncology follow-up, routine monitoring with MRI and formal neurocognitive evaluation are imperative to provide early recognition of disease progression or recurrent hydrocephalus and to improve school functioning in this population.
authors.affiliation: Cancer and Blood Diseases Institute, Division of Oncology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA, davegass19@gmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Gass
authors.forename: Mariko
authors.initials: M
authors.lastname: Dewire
authors.forename: Lionel
authors.initials: L
authors.lastname: Chow
authors.forename: Susan R
authors.initials: SR
authors.lastname: Rose
authors.forename: Sarah
authors.initials: S
authors.lastname: Lawson
authors.forename: Charles
authors.initials: C
authors.lastname: Stevenson
authors.forename: Ahna L H
authors.initials: AL
authors.lastname: Pai
authors.forename: Blaise
authors.initials: B
authors.lastname: Jones
authors.forename: Mary
authors.initials: M
authors.lastname: Sutton
authors.forename: Adam
authors.initials: A
authors.lastname: Lane
authors.forename: David
authors.initials: D
authors.lastname: Pruitt
authors.forename: Maryam
authors.initials: M
authors.lastname: Fouladi
authors.forename: Trent R
authors.initials: TR
authors.lastname: Hummel
mesh_terms: D000293:Adolescent; D020295:Brain Stem Neoplasms / Q000150:complications* / Q000473:pathology / Q000523:psychology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004700:Endocrine System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000150:complications* / Q000473:pathology / Q000523:psychology; D006801:Humans; D007223:Infant; D008297:Male; D009367:Neoplasm Staging; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011379:Prognosis; D012189:Retrospective Studies; D003336:Tectum Mesencephali / Q000473:pathology* / Q000601:surgery