Hypothalamic glioma

Alternative names 
Hypothalamic tumor

Definition
Hypothalamic tumor is a growth in the hypothalamus, a centrally located part of the brain.

Causes, incidence, and risk factors

The exact cause of hypothalamic tumors is not known. It is likely that they result from a combination of genetic and environmental factors.

In children, most hypothalamic tumors are gliomas. Gliomas are a common type of brain tumor that result from the abnormal growth of glial cells, which are a type of cells that support nerve cells. Gliomas can occur at any age but they are often more aggressive in adults than children.

In adults, tumors in the hypothalamus are more likely to be metastatic (resulting from the spread of cancer from another organ to the hypothalmus) than they are when they occur in children.

Neurofibromatosis is a heriditary condition that is a risk factor for these type of tumors. Radiation is also a risk for tumors, although the exact risk for this type of tumor is uncertain.

Symptoms

These tumors can cause a range of symptoms:

     
  • Cachexia (loss of body fat and appetite)  
  • Hyperactivity  
  • Euphoric “high” sensations  
  • Headache  
  • Failure to thrive (lack of normal growth in children)

Such symptoms are most frequently seen in children whose tumors affect the anterior (front) portion of the hypothalamus.

Some tumors may extend to the visual pathways, which can cause loss of vision. If the tumors block the flow of spinal fluid, headaches and sleepiness may result from hydrocephalus (collection of fluid in the brain).

Some patients can have seizures as a result of brain tumors.

Signs and tests

Your health care provider may identify an abnormal development during a regular checkup. He or she will perform a neurological exam, including testing of visual function. Blood tests for hormone imbalances may also be performed.

Depending on the results of the examination and blood tests, a CT scans or MRI scan can determine the presence of hypothalamic tumors.

Visual field testing may provide more information about severely affected vision is and can help determine if the condition is improving or worsening.

Treatment

The treatment depends on the aggressiveness of the tumor and whether it is a glioma or another type of cancer. Treatment options involve combinations of surgery, radiation, and chemotherapy.

Special radiation treatments can be focused on some tumors (Gamma knife) and can be as effective as surgery but pose less risk to surrounding tissue. Brain swelling caused by a tumor may need to be treated with steroids.

Hypothalamic tumors may produce hormones or alter hormone production, leading to imbalances that may need to be corrected. In some cases, hormone replacement or suppression may be necessary.

Support Groups
There are nationwide and state support groups for patients with hypothalamic tumors and their families, which may be found via an Internet search.

Expectations (prognosis)

Prognosis depends on several factors:

     
  • Type of tumor (i.e., glioma or other type)  
  • Location of the tumor  
  • Grade of tumor  
  • Size of tumor  
  • Age and general health of the patient.

In general, gliomas in adults are more aggressive than in children and usually indicate a worse outcome. Tumors causing hydrocephalus may cause additional complications, such as requirement for surgery.

Complications

Complications of brain surgery may include the following:

     
  • Bleeding  
  • Infection  
  • Brain damage  
  • Death (rarely)

Seizures can result from the tumor or from any surgical procedure on the brain.

Hydrocephalus can occur with some tumors and can require surgery or a catheter placement in the brain to reduce spinal fluid pressure.

Risks of radiation therapy include damage to healthy brain cells along with destruction of the tumor cells.

Common side effects from chemotherapy include loss of appetite, nausea and vomiting, and fatigue.

Calling your health care provider

Call your health care provider if you or your child develops any symptoms of a hypothalamic tumor. Regular physical examinations may detect early signs of a problem, such as abnormal weight gain or abnormal puberty.

Be sure your child receives regular medical checkups.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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