[Giant optic glioma--case report (author's transl)]

Area of Science:

• Pediatric neurosurgery
• Neuro-oncology
• Ophthalmology

Background:

• Optic gliomas are tumors that affect the optic nerve, often presenting in children.
• Large optic gliomas can cause significant intracranial pressure and visual impairment.
• Surgical intervention is a primary treatment modality for accessible optic nerve tumors.

Observation:

• A 3.5-year-old girl presented with symptoms of increased intracranial pressure, including headache, vomiting, and altered consciousness.
• Neuroradiological examination revealed a large subfrontal-suprasellar mass.
• The patient underwent surgical resection of a massive tumor originating from the right optic nerve.

Findings:

• Histopathological analysis confirmed the tumor as a pilocytic astrocytoma.
• Complete tumor removal was achieved piecemeal.
• Postoperatively, the patient experienced transient diabetes insipidus and hypernatremia, which resolved within two months.
• A follow-up CT scan showed no residual mass.
• The patient was discharged with mild left hemiparesis and preserved visual acuity of 0.2 in the left eye, with blindness in the right eye.

Implications:

• This case highlights the feasibility of complete surgical resection for large optic nerve pilocytic astrocytomas in pediatric patients.
• Management of postoperative endocrine disturbances, such as diabetes insipidus, is crucial.
• Despite significant tumor burden and surgical intervention, functional recovery with preserved vision in one eye is possible.
• Long-term follow-up is essential to monitor for recurrence and manage potential late sequelae.