Optic pathway glioma

Case contributed by Dr Ammar Haouimi

Presentation

Progressive and bilateral loss of vision. No history of neurofibromatosis type 1 (NF1).

Patient Data

Age: 25 years
Gender: Male
MRI

There is an abnormal enlargement of the optic chiasma, intracranial segment of the optic nerves, and optic tracts of isosignal to the cortical grey matter on T1 and T2 with no enhancement on postcontrast sequences. High signal on FLAIR with no enhancement of the lateral geniculate bodies, hippocampi and pulvinar thalamic nuclei.

Case Discussion

The clinical history, the MRI features, and the distribution of the lesions are most consistent with an isolated optic pathway glioma.

Optic pathways gliomas are typically seen in children, often in the setting of NF1 and usually of low-grade.

In adults, optic pathway gliomas do occur but very rare and usually considered as aggressive tumors. In such cases, no association with NF1 has found. Also, the posterior extension (as in this case ) with the involvement of the optic chiasma and optic pathways is more common in sporadic cases than in the setting of NF1.

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