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Spontaneous Visual Improvement In Chiasmal Gliomas

Liu & Lessell, 1992Brain tumor

Liu, G. T., & Lessell, S. (1992). spontaneous visual improvement in chiasmal gliomas. American journal of ophthalmology, 114(2), 193–201. https://doi.org/10.1016/s0002-9394(14)73984-4

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Abstract

Three untreated patients with presumed chiasmal gliomas had spontaneous visual improvement, although serial magnetic resonance imaging in two of the patients showed the lesions to be unchanged. Two patients had evidence of neurofibromatosis. Three other patients with similar disease courses have been documented in the medical literature. These cases demonstrate that conservative management of optic chiasmal gliomas may sometimes be associated with favorable outcomes.

Case Details

Disease Location

Right optic nerve glioma

Personal Characteristics

22-year-old female, history of megacephaly, multiple cafe au lait spots, no family history.

Clinical Characteristics

22-year-old female referred for chiasmatic tumor. Megacephaly and cafe au lait spots present but no nf history in family. Lisch nodules bilateral. Visual defect present. Follow up exam at 6 months, 15 months unchanged. No treatment given. At 24yo age, visual acuity improved however visual field improved. MRI confirmed a suprachiasmatic mass with extension into right optic n. A small focus seen in cerebellum. At 26yo age, improved vision and visual field defects. MRI unchanged. Last follow up at 27to age.

Remission Characteristics

No treatment given. At 24yo age, visual acuity improved however visual field improved. MRI confirmed a suprachiasmatic mass with extension into right optic nerve. A small focus was seen in the cerebellum. At 26yo age, improved vision and visual field defects. MRI unchanged. Last follow up at 27yo age.

Treatment & Mechanisms

Proposed Remission Mechanisms

Possible tumor cell necrosis or immune mechanism

Clinical Treatment

None reported

Non-Clinical Treatment

None reported