Chiasmatic gliomas with diencephalic syndrome in infants: challenges in the diagnosis and treatment

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Abstract

Infant hypothalamic-chiasmatic gliomas demonstrate aggressive behavior and poor response to chemotherapy. Diencephalic syndrome is often the first and, for a long time, the only symptom of these tumors, which leads to diagnostic delay. Diencephalic syndrome has been reported as an adverse prognostic factor in pediatric low-grade gliomas. Alternative therapies such as novel molecular targeted therapies are particularly needed for these patients. Here we report two clinical cases of infants with KIAA1549–BRAF rearranged hypothalamic/chiasmatic gliomas who presented with diencephalic syndrome and progressed on standard chemotherapy. Treatment with the MEK inhibitor trametinib resulted in a significant reduction in tumor size and the normalization of the weight curve in both cases. The patient's parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.

About the authors

L. I. Papusha

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: ludmila.mur@mail.ru
ORCID iD: 0000-0001-7750-5216

Ludmila I. Papusha, Cand. Med. Sci., a pediatric oncologist, Head of the Department of Optimization of CNS Tumor Therapy

117997, Moscow, Samory Mashela St., 1

Russian Federation

A. A. Merishavyan

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

Moscow

Russian Federation

M. A. Zaytseva

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0003-2015-5790

Moscow

Russian Federation

V. A. Degtyarev

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

Moscow

Russian Federation

Yu. A. Alymova

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

Moscow

Russian Federation

A. E. Druy

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation; Research Institute of Medical Cell Technologies

ORCID iD: 0000-0003-1308-8622

Moscow
Yekaterinburg

Russian Federation

A. I. Karachunskiy

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-9300-198X

Moscow

Russian Federation

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Copyright (c) 2022 Papusha L.I., Merishavyan A.A., Zaytseva M.A., Degtyarev V.A., Alymova Y.A., Druy A.E., Karachunskiy A.I.

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This work is licensed under a Creative Commons Attribution 4.0 International License.