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Unilateral adult malignant optic nerve glioma

  • Clinical Investigation
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Abstract

Introduction

Adult malignant optic nerve gliomas are rare and rapidly fatal visual pathway tumours. They represent a clinical entity different from the more common childhood benign optic nerve gliomas, which are frequently associated with neurofibromatosis I.

Case report

A 61-year-old woman presented with rapidly progressing right vision loss, lower altitudinal visual field defect and papilloedema. MRI showed intraorbital and intracranial swelling of the right optic nerve. Resection of the intracranial part of the right optic nerve up to the chiasm revealed anaplastic astrocytoma grade III. Within 1 year, the patient died of leptomeningeal metastasis despite radiotherapy. Clinical and MRI evaluation of the left eye and optic nerve were normal at all times.

Discussion

Unilateral adult malignant glioma of the optic nerve is exceptional. The final diagnosis was only confirmed by optic nerve biopsy. In the literature, only one patient has been reported with a unilateral tumour manifestation; he was lost to follow-up 3 months later. All other cases were bilateral. To date, 44 case reports of adult malignant optic nerve glioma have been published, either malignant astrocytoma or glioblastoma. These tumours can mimic optic neuritis in their initial presentation. The diagnosis is seldom made before craniotomy. On MRI images, malignant glioma cannot be distinguished from optic nerve enlargement due to other causes. Although radiotherapy appears to prolong life expectancy, all presently available treatment options (radiation, surgery, radio-chemotherapy) are of limited value. Most patients go blind and die within 1 or 2 years.

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References

  1. Albers GW, Hoyt WF, Forno LS, Shratter LA (1988) Treatment response in malignant optic glioma of adulthood. Neurology 38:1071–1074

    CAS  PubMed  Google Scholar 

  2. Apple DJ, Rabb MF (1991) Ocular pathology: Clinical applications and self-assessment. Mosby, New York

    Google Scholar 

  3. Barbaro NM, Rosenblum ML, Maitland CG, Hoyt WF, Davis RL (1982) Malignant optic glioma presenting radiologically as a “cystic” suprasellar mass: case report and review of the literature. Neurosurgery 11:787–789

    CAS  PubMed  Google Scholar 

  4. Condon JR, Rose FC (1967) Optic nerve glioma. Br J Ophthalmol 51:703–706

    CAS  PubMed  Google Scholar 

  5. Dario A, Iadini A, Cerati M, Marra A (1999) Malignant optic glioma of adulthood. Case report and review of the literature. Acta Neurol Scand 100:350–353

    CAS  PubMed  Google Scholar 

  6. Evens PA, Brihaye M, Buisseret T, Storme G, Solheid C, Brihaye J (1987) Gliome malin du chiasma chez l’adulte. Bull Soc Belge Ophtalmol 224:59–60

    CAS  PubMed  Google Scholar 

  7. Friedman DP, Hollander MD (1998) Neuroradiology case of the day. Malignant optic glioma of adulthood. Radiographics 18:1046–1048

    CAS  PubMed  Google Scholar 

  8. Gayre GS, Scott IU, Feuer W, Saunders TG, Siatkowski RM (2001) Long-term visual outcome in patients with anterior visual pathway gliomas. J Neuroophthalmol 21:1–7

    CAS  PubMed  Google Scholar 

  9. Gibberd FB, Miller TN, Morgan AD (1973) Glioblastoma of the optic chiasm. Br J Ophthalmol 57:788–791

    CAS  PubMed  Google Scholar 

  10. Hamilton AM, Garner A, Tripathi RC, Sanders MD (1973) Malignant optic nerve glioma. Report of a case with electron microscope study. Br J Ophthalmol 57:253–264

    CAS  PubMed  Google Scholar 

  11. Harper CG, Stewart-Wynne EG (1978) Malignant optic gliomas in adults. Arch Neurol 35:731–735

    CAS  PubMed  Google Scholar 

  12. Hoyt WF, Meshel LG, Lessell S, Schatz NJ, Suckling RD (1973) Malignant optic glioma of adulthood. Brain 96:121–132

    CAS  PubMed  Google Scholar 

  13. Hufnagel TJ, Kim JH, Lesser R, et al (1988) Malignant glioma of the optic chiasm 8 years after radiotherapy for prolactinoma. Arch Ophthalmol 106:1701–1705

    CAS  PubMed  Google Scholar 

  14. Jamshidi S, Korengold M, Kobrine AI (1984) Computed tomography of an optic chiasm glioma in an elderly patient. Surg Neurol 21:83–87

    CAS  PubMed  Google Scholar 

  15. Manor RS, Israeli J, Sandbank U (1976) Malignant optic glioma in a 70-year-old patient. Arch Ophthalmol 94:1142–1144

    CAS  PubMed  Google Scholar 

  16. Millar WS, Tartaglino LM, Sergott RC, Friedman DP, Flanders AE (1995) MR of malignant optic glioma of adulthood. AJNR Am J Neuroradiol 16:1673–1676

    CAS  PubMed  Google Scholar 

  17. Murphy M, Timms C, McKelvie P, Dowling A, Trost N (2003) Malignant optic nerve glioma: metastases to the spinal neuraxis. Case illustration. J Neurosurg 98:110

    PubMed  Google Scholar 

  18. Pallini R, Lauretti L, La Marca F (1996) Glioblastoma of the optic chiasm. J Neurosurg 84:898–899

    CAS  PubMed  Google Scholar 

  19. Parsa CF, Hoyt CS, Lesser RL, et al (2001) Spontaneous regression of optic gliomas: 13 cases documented by serial neuroimaging. Arch Ophthalmol 119:516–529

    CAS  PubMed  Google Scholar 

  20. Pick A (1901) On the study of true tumours of the optic nerve. Brain 24:502–508

    Google Scholar 

  21. Rao NA, Spencer WH (1991) Optic nerve. In: Spencer WH (ed.) Ophthalmic pathology: An atlas and textbook. W.B. Saunders, Philadelphia, pp 513–622

  22. Rudd A, Rees JE, Kennedy P, Weller RO, Blackwood W (1985) Malignant optic nerve gliomas in adults. J Clin Neuroophthalmol 5:238–243

    CAS  PubMed  Google Scholar 

  23. Saebo J (1949) Primary tumour of the optic nerve. Br J Ophthalmol 33:701–708

    Google Scholar 

  24. Safneck JR, Napier LB, Halliday WC (1992) Malignant astrocytoma of the optic nerve in a child. Can J Neurol Sci 19:498–503

    CAS  PubMed  Google Scholar 

  25. Shapiro SK, Shapiro I, Wirtschafter JD, Mastri AR (1982) Malignant optic glioma in an adult: initial CT abnormality limited to the posterior orbit, leptomeningeal seeding of the tumor. Minn Med 65:155–159

    CAS  PubMed  Google Scholar 

  26. Spoor TC, Kennerdell JS, Martinez AJ, Zorub D (1980) Malignant gliomas of the optic nerve pathways. Am J Ophthalmol 89:284–292

    CAS  PubMed  Google Scholar 

  27. Taphoorn MJ, Vries-Knoppert WA, Ponssen H, Wolbers JG (1989) Malignant optic glioma in adults. Case report. J Neurosurg 70:277–279

    CAS  PubMed  Google Scholar 

  28. Valdueza JM, Cristante L, Freitag J, Hagel C, Herrmann HD (1995) Malignant chiasmal glioma: a rare cause of rapid visual loss. Neurosurg Rev 18:273–275

    CAS  PubMed  Google Scholar 

  29. Woiciechowsky C, Vogel S, Meyer R, Lehmann R. (1995) Magnetic resonance imaging of a glioblastoma of the optic chiasm. Case report. J Neurosurg 83:923–925

    CAS  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank C. Sing for the English revision.

Author information

Authors and Affiliations

  1. Department of Paediatric Ophthalmology, Strabismology and Ophthalmogenetics, University of Regensburg, Franz Josef Strauss Allee 11, 93053, Regensburg, Germany

    Bettina Wabbels, Anke Demmler & Birgit Lorenz

  2. Institute of Radiology, University of Regensburg, Regensburg, Germany

    Johannes Seitz

  3. Institute of Pathology, University of Regensburg, Regensburg, Germany

    Matthias Woenckhaus

  4. Department of Neurosurgery, University of Regensburg, Regensburg, Germany

    Heinz-Georg Bloß

Authors
  1. Bettina Wabbels
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  2. Anke Demmler
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  3. Johannes Seitz
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  4. Matthias Woenckhaus
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  5. Heinz-Georg Bloß
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  6. Birgit Lorenz
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Corresponding author

Correspondence to Bettina Wabbels.

Additional information

This paper was presented in part at the 101st Meeting of the German Ophthalmological Society (DOG).

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Wabbels, B., Demmler, A., Seitz, J. et al. Unilateral adult malignant optic nerve glioma. Graefe's Arch Clin Exp Ophthalmol 242, 741–748 (2004). https://doi.org/10.1007/s00417-004-0905-z

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  • DOI: https://doi.org/10.1007/s00417-004-0905-z

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