Spontaneous Regression Of A Massive Sporadic Chiasmal Optic Pathway Glioma.
Pruzan, N. L., de Alba Campomanes, A., Gorovoy, I. R., & Hoyt, C. (2015). spontaneous Regression of a Massive Sporadic Chiasmal optic Pathway Glioma. Journal of child neurology, 30(9), 1196–1198. https://doi.org/10.1177/0883073814546686
View Original Source →Abstract
Optic pathway gliomas have highly variable and unpredictable natural histories, including spontaneous regression, making management decisions difficult and controversial. We report a case of substantial spontaneous regression of an optic pathway glioma involving the chiasm in a 15-month-old boy. Our case is particularly striking given the massive size at presentation with chiasmal, bilateral optic tract, and midbrain involvement, along with clinical ophthalmologic signs for which the majority of practitioners may have recommended treatment on presentation.
Case Details
Disease Location
Optic chiasm, bilateral tract, midbrain
Personal Characteristics
15- months-old male
Clinical Characteristics
A 15- months-old male presented with bilateral nystagmus. MRI of the brain revealed an intensely enhancing mixed cystic and solid optic pathway glioma involving the optic chiasm and both optic tracts, right greater than left, with peritumoral edema and mass effect causing partial effacement of the right lateral ventricle. There was mild obstruction of the cerebral aqueduct from direct involvement of the midbrain resulting in mild left lateral ventriculomegaly. There were peritumoral septemberated, complex arachnoid cysts crossing the midline, right greater than left: unrelated to the tumor.
Remission Characteristics
As per the wishes of the patient’s family, observation was undertaken with serial examinations and imaging. Over the next several months, the patient’s visual
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed