Enlarging optic chiasmal glioma with stable visual acuity

Area of Science:

• Neuro-oncology
• Pediatric neurosurgery
• Ophthalmology

Background:

• Optic pathway gliomas are tumors that affect the optic nerves, optic chiasm, and parts of the brain controlling vision.
• These tumors can present in childhood and may be associated with neurofibromatosis type 1.
• Early detection and accurate diagnosis are crucial for effective management.

Observation:

• A 13-year-old girl presented with a history of stable, reduced visual acuity, nystagmus, and small, pale optic discs noted since infancy.
• She later developed symptoms indicative of increased intracranial pressure.
• These clinical signs suggested a progressive neurological condition.

Findings:

• Craniotomy revealed an intrinsic glioma originating from the optic chiasm and optic nerves.
• The tumor demonstrated extensive infiltration into the frontal lobes, hypothalamus, and third ventricle.
• This indicated a widespread and aggressive tumor growth pattern.

Implications:

• This case highlights the potential for optic pathway gliomas to present with delayed symptoms and significant intracranial extension.
• Aggressive tumor growth can lead to severe neurological deficits and increased intracranial pressure.
• Multidisciplinary management involving neurosurgery, oncology, and ophthalmology is essential for optimizing patient outcomes.