Bilateral Thalamic Glioma in a 10-yearold Child: An Unusual Case Report

Bilateral thalamic gliomas are extremely rare tumours of the central nervous system. Although they are usually benign in nature, their outcome is poor because of the involvement of thalamic nuclei and inadequate surgical excision, making their excision extremely difficult. A 10-year-old girl presented with right-sided abnormal body movements for 2 months, fever for 10 days, followed by right-sided weakness, left facial palsy, and blurred vision in the left eye. Neurological examination showed right hemiparesis and left seventh nerve palsy. Magnetic Resonance Imaging (MRI) revealed bilateral thalamic lesions with a left-sided mass extending to the midbrain, and MR spectroscopy findings were suggestive of a bilateral low-grade glioma. She was started on antibiotics, and a stereotactic brain biopsy was planned. The present index case highlights the rarity of thalamic tumours in the paediatric population; wherein early diagnosis helps in prognosticating the family/caregivers of the child. However, the decision for further management is up to the parents, considering that the poor prognosis of the disease process and the associated morbidity and mortality is crucial. Management primarily includes tumor excision along with chemotherapy and radiotherapy, which entails a poor prognosis.