title: Tectal glioma presenting with clinical triad of obesity, amenorrhea and central cord syndrome with radiological pentad of hydrocephalus, empty sella, suprapineal diverticula, Chiari and syrinx.
abstract: BACKGROUND
  Tectal gliomas (TG) are slow-growing tumors and generally present with features of increased intracranial pressure.
  
  
  METHODS
  We describe an unusual case of a young girl who presented with clinical triad of obesity, primary amenorrhea and central cord syndrome. The radiology unveiled a pentad of hydrocephalus, empty sella, suprapineal recess diverticulum, secondary Chiari malformation and cervical syringomyelia, masking a relatively obscure tectal plate glioma. She was subjected to endoscopic third ventriculostomy (ETV). All of her symptoms improved after ETV and the tumor is being followed up. The possible pathogenesis of such a highly atypical clinico-radiological presentation is described.
  
  
  CONCLUSIONS
  This unusual syndromic presentation of tectal glioma without clinical features of increased intracranial pressure is probably due to increased compliance of third ventricular walls, and is relieved with ETV.
authors.affiliation: Department of Neurosurgery, Post-Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India. ssdhandapani.neurosurg@gmail.com.
authors.forename: Sivashanmugam
authors.identifier: http://orcid.org/0000-0002-3497-4255
authors.initials: S
authors.lastname: Dhandapani
authors.affiliation: Department of Neurosurgery, Post-Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India.
authors.forename: Madhivanan
authors.initials: M
authors.lastname: Karthigeyan
authors.affiliation: Department of Neurosurgery, Post-Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India.
authors.forename: Sushanta K
authors.initials: SK
authors.lastname: Sahoo
authors.affiliation: Department of Radiology, PGIMER, Chandigarh, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D000568:Amenorrhea / Q000209:etiology*; D020295:Brain Stem Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D020210:Central Cord Syndrome / Q000209:etiology; D004652:Empty Sella Syndrome / Q000209:etiology; D005260:Female; D005910:Glioma / Q000150:complications*; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D009765:Obesity / Q000209:etiology*; D014696:Ventriculostomy / Q000379:methods*
keywords: Chiari; Empty sella; Endoscopic third ventriculostomy; Hydrocephalus; Suprapineal recess diverticulum; Syringomyelia; Tectal glioma