Neurology India Medknow Publications on behalf of the Neurological Society of India ISSN: 0028-3886 EISSN: 1998-4022 Vol. 59, Num. 1, 2011, pp. 144-144

Neurology India, Vol. 59, No. 1, January-February, 2011, pp. 144

Correspondence

Optic chiasmatic-hypothalamic gliomas: Is tissue diagnosis essential?

Mostafa El Khashab¹, Farideh Nejat²

¹ Department of Neurosurgery, Hackensack University Medical Center, New Jersey, and Section of Pediatric Neurosurgery, Saint Barnabas Medical Center, Livingston, New Jersey, USA
² Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran, Iran
Correspondence Address: Farideh Nejat, Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Science, Tehran, Iran, nejat@sina.tums.ac.ir

Date of Submission: 12-Dec-2010
Date of Decision: 12-Dec-2010
Date of Acceptance: 12-Dec-2010

Code Number: ni11046

PMID: 21339694
DOI: 10.4103/0028-3886.76890

Sir,

We read with great interest the article by Bommakanti et al. ^[1] concerning the imaging characteristics of optic chiasmatic hypothalamic gliomas (OCHGs). The authors described the radiological features of OCHGs in 24 patients and identified pathological entities that were similar to OCHGs. They tried to analyze the sensitivity and specificity of magnetic resonance imaging (MRI) for these suprasellar lesions. They demonstrated a sensitivity of 83.33% and a specificity of 50% for MRI in the diagnosis of OCHG. Finally they concluded biopsy and tissue diagnosis should always be performed before advocating radiotherapy or chemotherapy for suspicious cases of OCHG.

In our experience of managing children with suprasellar mass, we have observed an MRI feature typical to OCHG. This characteristic feature is especially seen in the axial view of brain MRI; it involves optic nerve from optic canal to chiasma. The tumor tapers when extending anteriorly to involve the optic nerve, and there is no lesion in the suprasellar area with this pattern. It shows continuity of the nerve and tumor expansion of chiasma that the tumor is gradually narrowed to attach the optic nerve. Based on these observations, we suggest taking accurate slices of axial MRI in suspicious cases of OCHG to demonstrate the nerve and the tumor in one cut. This view should reveal the continuity of nerve and the tumor in the way that the nerve is reaching to chiasma. This finding is highly characteristic of OCHG and no other tumors are tapered to arrive the nerve and involve it.

References

1.	Bommakanti K, Panigrahi M, Yarlagadda M, Sundaram C, Uppin MS, Purohit AK. Optic chiasmatic-hypothalamic gliomas: Is tissue diagnosis essential? Neurol India 2010;58:833-40.  Back to cited text no. 1  [PUBMED]

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