Presentation
Left side proptosis.
Patient Data
There is a large heterogeneous mass lesion involving the sellar and suprasellar region and the optic chiasm extending through the left orbital bony apex to the left orbital cavity with resultant proptosis.
The lesion is predominantly solid showing avid enhancement with some cystic areas. No calcification is seen in the lesion.
The intracranial parts of the lesion show mass effect over the medial aspects of both frontal lobes including the intracranial parts of the internal carotid arteries, the middle cerebral arteries, and the anterior cerebral arteries.
Posteriorly the lesion is reaching the prepontine cistern and abutting the basilar artery.
The size of the mass lesion in the cranial fossa is 6.4 x 3.6 x 4.2 cm in TR, AP, and CC dimensions.
The left intra-orbital components of the lesion measure 2.8 x 1.9 x 2.2 cm in AP, TR, and CC dimensions.
The left optic nerve is not clearly separately seen from the lesion. The left eyeball itself is normal.
Case Discussion
The features are in favor of optic pathway glioma.
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