Background: Gliomas involving the corpus callosum (CC) are rare and pose significant neurosurgical challenges due to their deep midline location, bilateral spread, and potential for neurocognitive impairment. Historically considered inoperable, these tumors are now being managed more aggressively with advances in imaging and molecular diagnostics.Objective: To describe the clinical presentation, radiological features, surgical outcomes, histopathological findings, and molecular profiles of corpus callosal gliomas in a tertiary care centre in India.Methods: We retrospectively analysed four patients with gliomas involving the corpus callosum who underwent surgical resection in 2024. Clinical data, Karnofsky Performance Score (KPS)MRI findings, extent of resection, histopathology, immunohistochemistry (IDH1, ATRX, p53, Ki-67), and postoperative management were reviewed.Results: The series included two cases of IDH-mutant astrocytoma (WHO Grade 4), one anaplastic oligodendroglioma (WHO Grade 3), and one low-grade oligodendroglioma (WHO Grade 2). All tumors were IDH1 R132H mutant. Presenting symptoms included headache, motor weakness, cognitive changes, and altered sensorium. MRI revealed characteristic features including T2/FLAIR hyperintensity, irregular enhancement, diffusion restriction, and "butterfly" pattern in midline-crossing lesions. Surgical resection (subtotal to near-total) was achieved in all cases via tailored craniotomies. Adjuvant chemoradiotherapy was initiated in survivors. One patient (KPS 20 at presentation) succumbed to postoperative sepsis on day 12.Conclusion: Despite historical perceptions of poor prognosis and inoperability, aggressive surgical resection combined with adjuvant therapy and molecular characterization can improve outcomes in corpus callosal gliomas. Integration of advanced imaging, individualized surgical planning, and IDH-based molecular diagnostics is essential for optimizing survival and functional recovery, even in resource-limited settings.
Soni et al. (Thu,) studied this question.