Diagnostic characteristics of optic chiasm-hypothalamic glioma and its high misdiagnosis rate
10.3760/cma.j.issn.1671-8925.2012.07.013
- VernacularTitle:视交叉——下丘脑胶质瘤的诊断特点及高误诊率分析
- Author:
Han-Wen LIU
1
;
Song-Tao QI
;
Yun-Tao LU
;
Jun PAN
;
Yan-Yi YIN
Author Information
1. 江西省赣州市市立医院
- Keywords:
Glioma;
Diagnostic feature;
Imaging analysis;
Misdiagnosis
- From:
Chinese Journal of Neuromedicine
2012;(7):699-702
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To investigate the diagnostic characteristics of optic chiasm-hypothalamic glioma (OCHG) and the reasons for its high misdiagnosis rate.[Methods]Retrospective analysis was performed on the clinical features and imaging findings of 32 patients with OCHG,admitted to our hospitals from October 1999 to December 2011 and proved by pathology.Being compared with those features of other diseases in the sellar region,the reasons for high misdiagnosis rate of OCHG were analyzed.[Results] Among the 32 patients,18 were diagnosed correctly before surgery.However,in the other 14,lesions were misdiagnosed as craniopharyngioma in 8,germ cell tumor in 4,pituitary adenoma in 1,and chordoma in 1 with a total misdiagnosis rate reaching 43％.All patients suffered craniotomy surgery for tumor removal.Among the 4 patients misdiagnosed as having germinoma,2 underwent preoperative radiotherapy and 2 performed preoperative EP regimen chemotherapy.According to the features of the CT and MR images,the OCHG were divided into 3 presentations:solid,solid and cyst mixture and round enhanced tumors.The solid lesions (n=10) were easily misdiagnosed as germinoma (4/10,40％);however,the round enhanced tumors (n=5),especially combined with huge calcification (n=4),were extremely easily misdiagnosed as craniopharyngioma (4/5,80％ ).[Conclusion] Comprehensive understanding the growth and image features of OCHG and summing up the misdiagnosis points when comparing to the other diseases in the sellar region are indispensable in improving the presurgical diagnosis accuracy for OCHG.
