GLIAL TUMOURETTES (GLIAL MICROTUMOURS) - THEIR CLINICAL AND HISTOPATHOLOGICAL MANIFESTATIONS

This study represents our experience with eight cases (males: 4; femal es: 4; 13-47 years old, average age 28.5 years) of a ''glial tumourett e'' (minute glioma), which measured less than 15 mm in diameter on an MRI. Four tumours were located in the frontal lobe, one in the rostrum of the corpus callosum, two in the midbrain, and one in the thalamus. The symptoms and signs lasted from two days to 15 months prior to dia gnosis, and they consisted of epileptic seizures in five patients and increased intracranial pressure due to hydrocephalus resulting from aq ueductal stenosis in three. All patients had a CT scan and an MRI as a part of their initial neuro-imaging evaluations. While the CT finding s failed to show the lesion in four patients, MRI demonstrated it in a ll cases. Five tumours were either totally or subtotally removed while the remaining three were biopsied. Histological examinations revealed six tumours to be low-grade gliomas (fibrillary astrocytoma: 4; oligo -astrocytoma: 2) and two to be high-grade gliomas (anaplastic astrocyt oma: 1; anaplastic oligodendroglioma: 1). Regarding adjuvant therapy, three patients received radiation and/or chemotherapy. One of the pati ents with midbrain fibrillary astrocytoma died of the disease 38 month s after the operation, however, no evidence of progression in the rema ining seven has been observed in the follow-up period ranging from fiv e to 65 months after the operation (average: 25.4 months). The histoge nesis of benign and malignant gliomas and the importance of surgical e xploration in the management of such patients with minute intracerebra l tumours are also discussed.