Multicentric Glioblastoma Multiforme Mimicking Optic Neuritis

Area of Science:

• Neuro-oncology
• Ophthalmology
• Neurology

Background:

• Retrobulbar optic neuritis is an inflammatory condition affecting the optic nerve behind the eye.
• It typically presents with sudden, painless vision loss and visual field defects.
• Steroid treatment is the standard initial therapy for optic neuritis.

Observation:

• A 49-year-old woman presented with acute, painless right eye vision loss and a relative afferent pupillary defect.
• Fundus examination was normal, leading to an initial diagnosis of retrobulbar optic neuritis.
• Despite intravenous steroid treatment, her vision progressively worsened, with new visual field defects in the fellow eye.

Findings:

• Cranial magnetic resonance imaging (MRI) identified a mass at the right optic nerve-chiasm junction and a right frontal lesion.
• Biopsy confirmed the lesions to be multicentric glioblastoma multiforme, an aggressive brain tumor.
• This presentation highlights an unusual etiology for optic nerve compromise.

Implications:

• Glioblastoma multiforme can mimic inflammatory optic nerve conditions, necessitating a broad differential diagnosis.
• Clinicians should consider aggressive neoplasms in cases of atypical or treatment-refractory optic neuritis.
• Early and accurate diagnosis of CNS tumors is crucial for timely intervention and improved patient outcomes.