Surgical management of exophytic chiasmatic-hypothalamic tumors of childhood

J. H. Wisoff, R. Abbott, F. Epstein

Research output: Contribution to journalArticlepeer-review

124 Scopus citations


Sixteen children underwent 18 operations for radical resection of chiasmatic-hypothalamic tumors. The clinical presentation correlated with age: infants under 1 year of age presented with macrocephaly, failure to thrive, and severe visual failure; children aged 1 to 5 years predominantly had precocious puberty with mild visual deficits; and older children (> 5 years old) had slowly progressive loss of vision. All three infants had biologically aggressive tumors in spite of low-grade histology, and died from progressive tumor growth. Eleven of the 13 children aged 1 year or over are alive and well, without clinical or radiographic evidence of disease progression, 4 months to 4 1/2 years following surgery. Six of these patients, with a follow-up period of 10 months to 4 1/2 years (mean 27 months), have had no adjuvant therapy following radical surgical resection. The authors conclude that: 1) radical surgical resection of chiasmatic-hypothalamic tumors can be performed with minimal morbidity; 2) radical resection may delay the time to disease progression in older children and postpone the need for irradiation; 3) resection of postirradiation recurrent tumors may provide neurological improvement and long-lasting clinical remission; and 4) chiasmatic-hypothalamic tumors of infancy are aggressive neoplasms that require multimodality therapy.

Original languageEnglish (US)
Pages (from-to)661-667
Number of pages7
JournalJournal of neurosurgery
Issue number5
StatePublished - 1990
Externally publishedYes


  • astrocytoma
  • children
  • glioma
  • hypothalamus
  • optic glioma
  • radiation therapy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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