• Thalamic or Hypothalamic Astrocytoma Overview

    Thalamic or hypothalamic astrocytomas are a type of glioma, meaning that they arise in the brain’s glial or supportive tissues. These tumors develop in the thalamus—a deep-lying part of the brain responsible for identification of sensation, such as temperature, pain and touch, and a relay center for movement—or the hypothalamus—the brain area just below the thalamus responsible for hormone functioning, body temperature, sleep and appetite. Sometimes these tumors can invade both areas. 

    Thalamic or Hypothalamic Astrocytoma Treatment at Dana-Farber/Boston Children's

    Children with thalamic or hypothalamic astrocytomas are treated at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center through our Glioma Program. Continue reading to learn more about thalamic or hypothalamic astrocystomas or visit the Glioma Program homepage to learn about our expertise and treatment options for this condition.

    Symptoms & Diagnosis

    Since thalamic or hypothalamic astrocytomas grow relatively slowly, a child may have been having symptoms for many months prior to diagnosis, or his symptoms may appear more suddenly. Many children with gangliogliomas first present with seizures. Other symptoms are associated with increased pressure in the brain, including:

    • Headache – generally upon awakening in the morning
    • Nausea and vomiting – often worse in the morning and improving throughout the day
    • Fatigue
    • Weakness on one side of the body
    • Symptoms of hormone imbalance, including weight loss/gain
    • Symptoms of salt and water imbalance, including retaining water, swelling and frequent urination
    • Changes in vision (since the thalamus and hypothalamus are found close to the visual pathway system in the brain)

    A physician may order a number of different tests to best diagnose the tumor. In addition to a physical exam, medical history and neurological exam (which tests reflexes, muscle strength, eye and mouth movement, coordination and alertness), those tests may include:

    • Magnetic resonance imaging (MRI)
    • Biopsy 

    After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    A number of treatments may be recommended for thalamic or hypothalamic astrocytomas. Some help treat the tumor, while others address complications of the disease or side effects of treatment. These include:

    • Neurosurgery – to remove as much of the tumor as safely possible; surgery is often limited due to the deep, central placement of the thalamus and hypothalamus in the brain
    • Chemotherapy – either before surgery to shrink the tumor or to kill cancer cells 
    • Radiation therapy – precisely targeted treatment to control local growth of tumors; not recommended unless the child’s tumor has re-grown due to potential long-term side effects of therapy

    Progressive or Recurrent Disease

    There are many standard and experimental treatment options for children with recurrent or progressive thalamic or hypothalamic astrocytomas. If a tumor recurs after initial surgical removal or the tumor re-grows after partial removal, a doctor may recommend a second attempt at removing as much of the tumor as possible.

    Long-term Outlook

    Children with thalamic or hypothalamic astrocytomas have a high rate of survival. The survival rate is not as high if the tumor can’t be removed completely during surgery or if the tumor returns.
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