An infant with hyperalertness, hyperkinesis, and failure to thrive: a rare diencephalic syndrome due to hypothalamic anaplastic astrocytoma

BMC Cancer. 2015 Sep 4:15:616. doi: 10.1186/s12885-015-1626-x.


Background: Diencephalic Syndrome is a rare clinical condition of failure to thrive despite a normal caloric intake, hyperalertness, hyperkinesis, and euphoria usually associated with low-grade hypothalamic astrocytomas.

Case presentation: We reported an unusual case of diencephalic cachexia due to hypothalamic anaplastic astrocytoma (WHO-grade III). Baseline endocrine function evaluation was performed in this patient before surgery. After histological diagnosis, he enrolled to a chemotherapy program with sequential high-dose chemotherapy followed by hematopoietic stem cell rescue. The last MRI evaluation showed a good response. The patient is still alive with good visual function 21 months after starting chemotherapy.

Conclusions: Diencephalic cachexia can rarely be due to high-grade hypothalamic astrocytoma. We suggest that a nutritional support with chemotherapy given to high doses without radiotherapy could be an effective strategy for treatment of a poor-prognosis disease.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Astrocytoma / complications*
  • Astrocytoma / diagnosis
  • Astrocytoma / metabolism
  • Cachexia / etiology*
  • Failure to Thrive / etiology*
  • Humans
  • Hyperkinesis / etiology*
  • Hypothalamic Neoplasms / complications*
  • Hypothalamic Neoplasms / diagnosis
  • Hypothalamic Neoplasms / metabolism
  • Infant
  • Male