Surgical decision for adult optic glioma based on [18F]fluorodeoxyglucose positron emission tomography study

A 51-year-old male presented with a 5-year history of progressive right exophthalmos and visual loss. Magnetic resonance imaging showed a right intraorbital lesion. [(18)F]fluorodeoxyglucose positron emission tomography ([(18)F]FDG-PET) revealed high uptake in the tumor. No FDG was accumulated in the remaining optic tract. He underwent removal of the tumor. The histological diagnosis was optic glioma. Six months after the operation, the tumor recurred, and a second operation was performed to spare the visual acuity of the other eye, which remained stable for 1.5 years after the first operation. However, the patient died 2 years after the first operation of liver dysfunction. Adult optic glioma tends to rapidly extend into the surrounding tissue and to affect the contralateral visual pathway. Early diagnosis and surgical intervention are imperative. In the present case, [(18)F]FDG-PET was valuable for evaluating malignancy to determine whether radical surgery was indicated to preserve the remaining visual acuity.