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Hypothalamic-optochiasmatic glioma

Case contributed by Vinay Shah
Diagnosis almost certain

Presentation

Blurring of vision in both eyes.

Patient Data

Age: 25 years
Gender: Male

Diffuse thickening with lobulated mass lesion seen involving the optic chiasma, bilateral retro orbital optic nerves and optic tracks, which shows hypointense  on T1W images and hyperintense signal  on the T2W, FLAIR images. The lesion also involves the infundibular stalk and tuber cinereum. No evidence of any enhancement seen in the post contrast images. Preservation of the optic chiasma contour . 

The pituitary gland appears separate from the lesion and is compressed by the lesion.

Mild dilatation of the both the lateral ventricles.

Case Discussion

These findings represent a neoplastic pathology most likely a hypothalamic-optochiasmatic glioma.

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