Bilateral thalamic glioma

Case contributed by Dr Ammar Haouimi

Presentation

Gait disturbance with behavioural impairment

Patient Data

Age: 50 years
Gender: Male
MRI

The MRI sequences reveal bilateral thalamic mass, larger on the left thalamus. It appears of low signal intensity on T1WI, high signal intensity on FLAIR, and T2WI with a central area of very low signal on T1WI, and FLAIR, and high signal on T2WI. No surrounding edema nor enhancement following IV contrast. A mass effect is noted on the midbrain and 3rd ventricle with obstructive bi-ventricular hydrocephalus. No calcification or hemorrhage within the mass on gradient echo. 

MRS reveals an elevation of the choline as well as the choline/creatine, and choline/NAA ratios with myo-inositol spike.

Case Discussion

Bilateral thalamic gliomas are rare but considered as low-grade astrocytomas (World Health Organization grade II). They occur in both children and young adults.

Despite the treatment, the prognosis is usually very poor due to the deep location of such tumors.

 

Additional contributor: A Ramdani MD

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Case information

rID: 65729
Published: 21st Jan 2019
Last edited: 22nd Jan 2019
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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