Optic nerve glioma

Case contributed by Marta Legorburu Toña
Diagnosis certain

Presentation

Progressive exophthalmos in the last week, without a history of trauma or loss of visual acuity.

Patient Data

Age: 3 years
Gender: Male
ct

Fusiform thickening of the intraorbital segment of the right optic nerve with peripheral postcontrast enhancement. There is no affectation of the chiasm or hypothalamic involvement.

Mass effect is noted in the form of proptosis and indentation of the posterior wall of the eyeball.

mri

Fusiform thickening affecting the orbital and intracanalicular segment of the right optic nerve, which shows hyperintensity on both T1 and T2 with homogeneous postcontrast enhancement. No diffusion restriction.

It exerts mass effect with anterior bulging of the posterior wall of the eyeball and exophthalmos. No involvement of the optic chiasm, stem or pituitary gland is observed. 

Case Discussion

The findings are compatible with optic glioma as the first possibility. The patient was operated on with complete excision of the right optic nerve and eye enucleation.

The pathological examination confirmed the diagnosis of optic nerve glioma (pilocytic astrocytoma WHO grade I).

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