Pediatric thalamic incidentalomas: a retrospective analysis of
their characteristics, evolution, management, and prognostic
factors for progression

J 2025

Pediatric thalamic incidentalomas: a retrospective analysis of their characteristics, evolution, management, and prognostic factors for progression

TABORSKA, Jana; Katarina HORCICAKOVA; Adela BUBENIKOVA; Jakub TABORSKY; Martin KYNCL et al.

Základní údaje

Originální název

Pediatric thalamic incidentalomas: a retrospective analysis of their characteristics, evolution, management, and prognostic factors for progression

Autoři

TABORSKA, Jana; Katarina HORCICAKOVA; Adela BUBENIKOVA; Jakub TABORSKY; Martin KYNCL; Miroslav KOBLIZEK; David SUMERAUER; Michal ZAPOTOCKY; Zdeněk PAVELKA; Ondrej BRADAC a Vladimir BENES

Vydání

Acta neurochirurgica, Vienna, SPRINGER WIEN, 2025, 0001-6268

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Rakousko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 1.900 v roce 2024

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/25:00143757

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Incidentaloma; Thalamus; Pediatric tumor; Follow-up; Prognostic factors

Štítky

14110321, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 24. 2. 2026 12:27, Mgr. Tereza Miškechová

Anotace

V originále

Purpose: The increasing availability of advanced neuroimaging has led to a rise in incidental findings among pediatric patients. Management strategies include immediate surgical intervention, observation or surgery upon progression. These are influenced by imaging characteristics, lesion behavior over time, patient/family preferences, and the lesion's surgical risks. The thalamus's eloquent location often warrants a more conservative approach. Identifying features predictive of growth could help inform clinical decisions regarding surveillance and potential intervention. Methods: We retrospectively analyzed 44 pediatric patients with 46 thalamic incidentalomas, assessing radiological characteristics, temporal changes, and factors predictive of progression. Progression was defined as a change in size and/or new/increased contrast enhancement. Prognostic factors for progression (demographics, initial tumor volume, extension beyond thalamus, changes in enhancement, margin characteristics) were assessed for significance. Results: Of 46 incidentalomas, 40 were followed longitudinally. Nine incidentalomas (22.5%) showed regression, while nine (22.5%) progressed. The average time to regression was 947 days, and to progression, 516 days. Three patients underwent biopsy due to progressive changes; each was diagnosed with low-grade glioma. Statistical analysis revealed that initial incidentaloma volume, extension beyond the thalamus, and contrast enhancement were significantly associated with progression (p = 0.025, p < 0.001, and p = 0.001, respectively). Conclusions: Most pediatric thalamic incidentalomas are small, stable, and likely low-grade. However, approximately one-fifth exhibit progressive features, warranting prolonged surveillance. Larger initial volume, extra-thalamic extension, and contrast enhancement are significant predictors of progression and may justify earlier intervention. Individualized management remains essential, balancing natural history with surgical risk.

Citovat

TABORSKA, Jana; Katarina HORCICAKOVA; Adela BUBENIKOVA; Jakub TABORSKY; Martin KYNCL; Miroslav KOBLIZEK; David SUMERAUER; Michal ZAPOTOCKY; Zdeněk PAVELKA; Ondrej BRADAC a Vladimir BENES. Pediatric thalamic incidentalomas: a retrospective analysis of their characteristics, evolution, management, and prognostic factors for progression. Acta neurochirurgica. Vienna: SPRINGER WIEN, 2025, roč. 167, č. 1, s. 1-11. ISSN 0001-6268. Dostupné z: https://doi.org/10.1007/s00701-025-06632-2.

@article{2556439,
   author = {Taborska, Jana and Horcicakova, Katarina and Bubenikova, Adela and Taborsky, Jakub and Kyncl, Martin and Koblizek, Miroslav and Sumerauer, David and Zapotocky, Michal and Pavelka, Zdeněk and Bradac, Ondrej and Benes, Vladimir},
   article_location = {Vienna},
   article_number = {1},
   doi = {https://doi.org/10.1007/s00701-025-06632-2},
   keywords = {Incidentaloma; Thalamus; Pediatric tumor; Follow-up; Prognostic factors},
   language = {eng},
   issn = {0001-6268},
   journal = {Acta neurochirurgica},
   title = {Pediatric thalamic incidentalomas: a retrospective analysis of their characteristics, evolution, management, and prognostic factors for progression},
   url = {https://link.springer.com/article/10.1007/s00701-025-06632-2},
   volume = {167},
   year = {2025}
}

TY  - JOUR
ID  - 2556439
AU  - Taborska, Jana - Horcicakova, Katarina - Bubenikova, Adela - Taborsky, Jakub - Kyncl, Martin - Koblizek, Miroslav - Sumerauer, David - Zapotocky, Michal - Pavelka, Zdeněk - Bradac, Ondrej - Benes, Vladimir
PY  - 2025
TI  - Pediatric thalamic incidentalomas: a retrospective analysis of their characteristics, evolution, management, and prognostic factors for progression
JF  - Acta neurochirurgica
VL  - 167
IS  - 1
SP  - 1-11
EP  - 1-11
PB  - SPRINGER WIEN
SN  - 00016268
KW  - Incidentaloma
KW  - Thalamus
KW  - Pediatric tumor
KW  - Follow-up
KW  - Prognostic factors
UR  - https://link.springer.com/article/10.1007/s00701-025-06632-2
N2  - Purpose: The increasing availability of advanced neuroimaging has led to a rise in incidental findings among pediatric patients. Management strategies include immediate surgical intervention, observation or surgery upon progression. These are influenced by imaging characteristics, lesion behavior over time, patient/family preferences, and the lesion's surgical risks. The thalamus's eloquent location often warrants a more conservative approach. Identifying features predictive of growth could help inform clinical decisions regarding surveillance and potential intervention. Methods: We retrospectively analyzed 44 pediatric patients with 46 thalamic incidentalomas, assessing radiological characteristics, temporal changes, and factors predictive of progression. Progression was defined as a change in size and/or new/increased contrast enhancement. Prognostic factors for progression (demographics, initial tumor volume, extension beyond thalamus, changes in enhancement, margin characteristics) were assessed for significance. Results: Of 46 incidentalomas, 40 were followed longitudinally. Nine incidentalomas (22.5%) showed regression, while nine (22.5%) progressed. The average time to regression was 947 days, and to progression, 516 days. Three patients underwent biopsy due to progressive changes; each was diagnosed with low-grade glioma. Statistical analysis revealed that initial incidentaloma volume, extension beyond the thalamus, and contrast enhancement were significantly associated with progression (p = 0.025, p < 0.001, and p = 0.001, respectively). Conclusions: Most pediatric thalamic incidentalomas are small, stable, and likely low-grade. However, approximately one-fifth exhibit progressive features, warranting prolonged surveillance. Larger initial volume, extra-thalamic extension, and contrast enhancement are significant predictors of progression and may justify earlier intervention. Individualized management remains essential, balancing natural history with surgical risk.
ER  -

TABORSKA, Jana; Katarina HORCICAKOVA; Adela BUBENIKOVA; Jakub TABORSKY; Martin KYNCL; Miroslav KOBLIZEK; David SUMERAUER; Michal ZAPOTOCKY; Zdeněk PAVELKA; Ondrej BRADAC a Vladimir BENES. Pediatric thalamic incidentalomas: a retrospective analysis of their characteristics, evolution, management, and prognostic factors for progression. \textit{Acta neurochirurgica}. Vienna: SPRINGER WIEN, 2025, roč.~167, č.~1, s.~1-11. ISSN~0001-6268. Dostupné z: https://doi.org/10.1007/s00701-025-06632-2.

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