Improvement of diencephalic syndrome after partial surgery of optic chiasm glioma.

A 10-month-old male presented with sudden growth failure and cachexia. MRI showed a chiasma of the hypothalamic mass. Biopsy was avoided due to operative risks. Three cycles of chemotherapy were given, resulting in stable disease on MRI, but growth failure despite attempts at enteral feeding. Surgical biopsy was then performed. A 30% tumor reduction was observed on post-operative imaging. Pathological examination revealed a pilocytic astrocytoma. After surgery, the child gained weight and his growth curve returned to normal. Enteral feeding was discontinued. After 4-year of follow-up, neurological development remains normal, with no residual or endocrine abnormalities.