The behavior of the tanycytomas appears to be variable. Both older patients underwent complete resection of their tumors and have remained asymptomatic. The twenty six-year-old female underwent a course of focal external beam radiation therapy and the fifty six-year-old female did not receive any adjuvant therapy. The three pediatric patients underwent biopsies and debulking procedures. Two pediatric patients succumbed to their tumors less than a year after their diagnoses. These patients presented with larger hypothalamic-suprasellar tumors that were only partially resected. These tumors did not respond well to adjuvant therapy of radiation therapy and chemotherapy. The neoplasms continued to grow with eventual encasement of the distal internal carotid arteries. The four-year-old died secondary to cardiac arrest. The two-year-old died secondary to extensive cerebral infarctions of the internal carotid artery distributions (Figure 7).

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Figure 7. 2 ½-year-old female unresponsive

1. Axial T1-weighted contrast enhanced image: necrotic enhancing suprasellar mass encasing the distal internal carotid arteries.
2. Axial diffusion-weighted images: acute bilateral infarcts of the internal carotid artery territories.
3. Composite 3D Time of Flight MRA image: no blood flow beyond the supraclinoid portions of internal carotid arteries.
4. Sagittal maximum intensity projection image from 3D TOF MRA: no blood flow beyond the supraclinoid portions of the internal carotid arteries.
5. Axial CT scan image: massive bilateral infarctions of the internal carotid artery territories and suprasellar tumor mass (black arrows). (Obtained day after the previous MR images.)