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[Optic glioma in neonates--report of two cases]
1Department of Neurosurgery, Hirosaki University School of Medicine, Japan.
Insights
This study presents two rare neonatal optic glioma cases, diagnosed as fibrillary and anaplastic astrocytoma. Both patients show significant developmental delays, indicating a poor prognosis for these aggressive optic nerve tumors.
Area of Science:
- Neuro-oncology
- Pediatric ophthalmology
- Neuropathology
Background:
- Optic gliomas are rare pediatric tumors, with pilocytic astrocytoma being the most common subtype.
- Neonatal presentation of optic glioma is exceptionally rare, with limited documented cases.
Observation:
- Two neonates presented with lethargy and large chiasm-region tumors.
- Tumors were surgically challenging, with incomplete resection in both cases.
Findings:
- Histopathology revealed fibrillary astrocytoma (WHO grade II) in one neonate and anaplastic astrocytoma (WHO grade III) in the other.
- These diagnoses differ from the typical pilocytic astrocytoma found in infantile optic gliomas.
Implications:
- Aggressive astrocytic subtypes in neonatal optic gliomas are associated with poor functional outcomes.
- These cases highlight the need for further research into rare neonatal optic glioma subtypes and their management.
- Early detection and intervention strategies may be crucial for improving prognosis in affected infants.
Abstract:
We report two cases of optic glioma in neonates, which is rare and only 3 similar cases can be found in the literature so far. Case #1 was a 55-day-old boy having been lethargic since around his 25th postnatal day. Case #2 was a 100-day-old girl having also been in the same condition as Case #1 since around her 50th postnatal day. The tumor in either patients seemed to have originated from chiasm or its vicinity and were too large to remove totally. Histopathological diagnosis of the tumor was fibrillary astrocytoma grade II in Case #1, and was anaplastic astrocytoma grade III in Case #2, both of which are different from the most popular pilocytic astrocytoma in so called infantile optic glioma. Now, 5 months and 4 years respectively after the operation, mental and somatical developmental retardations are already seen in either patients. Their functional prognosis seems to be poor.