Optic pathway glioma

Case contributed by Dr Noriza Zainol Abidin

Presentation

Head shaking and bilateral nystagmus (spasmus mutans) noticable at 7 months of age.

Patient Data

Age: 2 years old
Gender: Female
MRI

Bilateral symmetrical fusiform enlargement and kinking of the optic nerves indicating optic nerve glioma. It extends intracranially involving both optic chiasm, optic tracts and lateral thalamic bilaterally. It exhibits isointense on T1, hyperintense on T2 and FLAIR. The lesions demonstrate heterogeneous enhancement following IV contrast administration. No cystic component is seen within. The lesions are bright on DWI images. No blooming artefact on GRE to suggest calcification or microhemorrhage.

Incidental findings of a small left temporal extra-axial arachnoid cyst.

Findings suggestive of bilateral optic pathway gliomas (OPGs) involving optic nerves, optic chiasm, optic tract and both lateral thalami.

Case Discussion

The involvement and distribution of the lesions are characteristic for optic pathway glioma (OPGs). Posterior extension involving the optic chiasm and optic pathway more common in sporadic cases compared to NF-1 related glioma. The extension indicates more agressive disease and poor clinical outcomes.

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Case information

rID: 52662
Case created: 16th Apr 2017
Last edited: 1st May 2017
Inclusion in quiz mode: Excluded

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