[Bilateral thalamic tumours. Three case reports and a review of the literature]. / Tumores talámicos bilaterales. Presentación de tres casos y revisión de la bibliografia.

INTRODUCTION: Thalamic tumours account for approximately 1% to 5% of all brain tumours, and are usually unilateral astrocytoma and frequently affect children. Bilateral thalamic tumours are very rare neoplasm, yet their actual incidence is unknown. AIMS: To report three children with bilateral thalamic tumours diagnosed in a 20 years period and to review the previously reported cases. CASE REPORTS: Here we report three children with bilateral thalamic tumours and review the previously reported cases diagnosed by angiography, computed tomography, and or magnetic resonance imaging. Twenty-six patients with bilateral thalamic tumours were analysed (13 children and 13 adults). Symptoms of mental impairment were present in 13 cases (50%) and sings of intracranial hypertension in 7 (26.9%). The pathology was confirmed in 22 patients (12 low grade gliomas and 10 high grade gliomas). In paediatric age there was a slight preponderance of low grade gliomas (7/12). The mean survival is 12.3 months (range: 7-36 months). CONCLUSIONS: Bilateral thalamic tumours are exceptional and have radiological and clinical features that differ from those of unilateral thalamic tumours. Today, the main role of surgery is still to obtain a histological diagnosis. The outcome of treatment for bilateral thalamic tumours remains poor, with only 7.6% of all patients surviving for more 12 months.

Tumores talámicos bilaterales. Presentación de tres casos y revisión de la bibliografía / Bilateral thalamic tumours three case reports and a review of the literature

Los tumores talámicos constituyen entre el 1 y el 5% de todos los procesos expansivos intracraneales,con frecuencia son de localización unilateral y tienen una mayor incidencia en la infancia. Los tumores talámicos bilaterales son excepcionales y su incidencia exacta no ha sido bien establecida hoy en día. Objetivos. Se presentan tres casos de tumorestalámicos bilaterales en niños y se analizan los casos publicados previamente. Casos clínicos. Se presentan tres casos de tumores talámicos bilaterales en edad pediátrica atendidos en un período de 20 años. Asimismo, se realiza una revisión de los casospublicados y diagnosticados mediante angiografía, tomografía computarizada o resonancia magnética. De la revisión de la bibliografía se analizan 26 casos de tumores talámicos bilaterales (13 niños y 13 adultos). Los síntomas predominantes fueron alteración cognitiva en 13 casos (50%) y signos de hipertensión intracraneal en 7 (26,9%). La histología fue confirmada en 22 casos (12 gliomas de bajo grado y 10 de alto grado); en la edad pediátrica existe un ligero predominio de los gliomas de bajo grado (7 a 12). La supervivencia media fue de 12,3 meses (rango: 7-36 meses). Conclusiones. Las neoplasias bitalámicas representan un grupo tumoral con características clínicas y radiológicas diferentes a los tumores unilaterales. La cirugía desempeñaun papel secundario en su tratamiento y se ciñe únicamente a la práctica de una biopsia con objetivo diagnóstico. El pronóstico es malo y sólo el 7,6% de los pacientes sobrevive más de 12 meses

Thalamic tumours account for approximately 1% to 5% of all brain tumours, and are usually unilateralastrocytoma and frequently affect children. Bilateral thalamic tumours are very rare neoplasm, yet their actual incidence is unknown. Aims. To report three children with bilateral thalamic tumours diagnosed in a 20 years period and to review the previously reported cases. Case reports. Here we report three children with bilateral thalamic tumours and review the previouslyreported cases diagnosed by angiography, computed tomography, and or magnetic resonance imaging. Twenty-sixpatients with bilateral thalamic tumours were analysed (13 children and 13 adults). Symptoms of mental impairment were present in 13 cases (50%) and sings of intracranial hypertension in 7 (26.9%). The pathology was confirmed in 22 patients (12 low grade gliomas and 10 high grade gliomas). In paediatric age there was a slight preponderance of low grade gliomas(7/12). The mean survival is 12.3 months (range: 7-36 months). Conclusions. Bilateral thalamic tumours are exceptional and have radiological and clinical features that differ from those of unilateral thalamic tumours. Today, the main role of surgery is still to obtain a histological diagnosis. The outcome of treatment for bilateral thalamic tumours remains poor, with only 7.6% of all patients surviving for more 12 months