Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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March 6, 2014
Tectal Glioma
- Brainstem gliomas comprise 2–4% of pediatric low-grade gliomas, including diffuse intrinsic pontine glioma, exophytic medullary glioma, and tectal glioma.
- Tectal glioma is a low-grade astrocytoma with an increased incidence in neurofibromatosis. Generally indolent, it has a benign clinical course.
- Clinical Presentation: Frequently asymptomatic, may evolve with hydrocephalus and, rarely, cranial nerve palsy, hemiparesis, or Parinaud syndrome.
- Key Diagnostic Features: Homogeneous expansion of tectal plate, isodense to grey matter on CT. Usually isointense on T1-weighted images, hyperintense on T2-weighted images, without contrast enhancement. Calcification has been reported in the literature, as seen in our case.
- DDx: Aqueductal stenosis, hamartoma (in NF1), ependymoma, ganglioglioma, primitive neuroectodermal tumor
- Rx: Shunting/ventriculostomy, radiation therapy/chemotherapy if increasing in size
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