The molecular oncology of bilateral high-grade thalamic astrocytomas in children

Background: Bilateral thalamic astrocytomas in children are exceedingly rare. These highly malignant tumors seldom respond to conventional treatment strategies and carry a grim prognosis for patients. However, recent advances in molecular oncology have had a positive impact on prognostication and treatment strategies of these tumors. Case-based review: We present a new case of WHO grade III bilateral thalamic astrocytoma in a child and review the pathophysiology, molecular oncogenesis, and relevant treatment strategies for this rare disease. Conclusions: High-grade thalamic astrocytomas affecting both thalami pose a challenge to pediatric neurosurgeons, neuro-oncologists, and neuropathologists given the lack of effective treatment strategies. Understanding recent revelations in the field of molecular oncology can assist clinicians in adequately formulating a treatment plan in this patient population.