Presentation
Left proptosis and diminished vision.
Patient Data
The intraorbital and intracanalicular segments of the left optic nerve show fusiform enlargement and expansion causing proptosis of the left eye-globe. It enhances intensely and homogeneously following administration of contrast.
The left eye-globe, orbital muscles and muscle cone are otherwise normal.
Case Discussion
This case demonstrates left optic nerve mass with no chiasmatic extension suggestive of optic nerve glioma. The differential diagnosis includes optic nerve sheath meningioma which surrounds and compresses the optic nerve. In this case, the optic nerve shows fusiform enlargement with kinking. MRI is more sensitive in detection and characterization of intracranial extension of the lesion through the optic pathway.