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Hypothalamic tumor
Definition
A hypothalamic tumor is an abnormal growth in the hypothalamus gland, which is located in the brain.
Alternative Names
Hypothalamic glioma
Causes
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 results 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 in children.
In adults, tumors in the hypothalamus are more likely cancer that has spread from another organ.
People with neurofibromatosis (a hereditary condition) are at increased risk for this type of tumor. People who have undergone radiation therapy are at increased risk for developing tumors in general.
Symptoms
These tumors can cause a range of symptoms:
- Euphoric "high" sensations
- Failure to thrive (lack of normal growth in children)
- Headache
- Hyperactivity
- Loss of body fat and appetite (cachexia)
These symptoms are most often seen in children whose tumors affect the front part of the hypothalamus.
Some tumors may cause vision loss. If the tumors block the flow of spinal fluid, headaches and sleepiness may result from fluid collecting in the brain (hydrocephalus).
Some patients can have seizures as a result of brain tumors. Other patients may develop precocious puberty from a change in pituitary gland function.
Exams and Tests
Your health care provider may see signs of a hypothalamic tumor during a regular checkup. He or she will perform a brain and nervous system (neurological) exam, including tests of visual function. Blood tests for hormone imbalances may also be done.
Depending on the results of the examination and blood tests, a CT scan or MRI scan can determine whether you have a hypothalamic tumor.
Visual field testing may be done to check for vision loss, and to determine whether the condition is improving or getting worse.
Treatment
The treatment depends on how aggressive the tumor is, and whether it is a glioma or another type of cancer. Treatment may involve combinations of surgery, radiation, and chemotherapy.
Special radiation treatments can be focused on the tumor. They can be as effective as surgery, with less risk to surrounding tissue. Brain swelling caused by a tumor may need to be treated with steroids.
Hypothalamic tumors may produce hormones or affect hormone production, leading to imbalances that may need to be corrected. In some cases, hormones may need to be replaced or reduced.
Support Groups
You can often help the stress of illness by joining a support group where members share common experiences and problems. See: Cancer - support group
Outlook (Prognosis)
The outlook depends on:
- The type of tumor (glioma or other type)
- Location of tumor
- Grade of tumor
- Size of tumor
- Your age and general health
In general, gliomas in adults are more aggressive than in children and usually have a worse outcome. Tumors that cause hydrocephalus may cause more complications, and may need surgery.
Possible Complications
Complications of brain surgery may include:
- Bleeding
- Brain damage
- Death (rarely)
- Infection
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 placed in the brain to reduce spinal fluid pressure.
Risks of radiation therapy include damage to healthy brain cells when tumor cells are destroyed.
Common side effects from chemotherapy include loss of appetite, nausea and vomiting, and fatigue.
When to Contact a Medical Professional
Call your health care provider if you or your child develops any symptoms of a hypothalamic tumor. Regular medical check-ups may detect early signs of a problem, such as abnormal weight gain or early puberty.
References
Molitch ME. Neuroendocrinology and the neuroendocrine system. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 230.
Deangelis LM. Tumors of the central nervous system and intracranial hypertension and hypertension. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 195.Reviewed By: Linda Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
