A BSTRACT Optic pathway gliomas represent a rare subset of pediatric brain tumors, frequently associated with neurofibromatosis type 1. Pilocytic astrocytoma (PA) (World Health Organization Grade I–II) is the most common histology, yet management of isolated optic nerve gliomas remains clinically challenging due to visual morbidity. We aim to present a rare case report of optic PA in a 6-year-old male who presented with progressive diminution of vision. Magnetic resonance imaging (MRI) findings were consistent with an optic chiasm region mass lesion. The patient underwent frontal craniotomy followed by a revision surgery and still had progressive diminution of vision, MRI suggestive of a large residual lesion along the optic chiasm extending to the thalamus region, so was started on adjuvant external beam radiotherapy to achieve better local control in patient and prevent progression. Posttreatment evaluation showed no change in visual status, but also no progression in optic mass lesion, and the patient remains stable at 6-week follow-up. This case highlights with a multidisciplinary discussion and treatment approach that must be taken care when treating patients. Early diagnosis and prompt intervention play a significant role in managing the cases, so that the visual status of the patient can be tried to preserve.
Dubey et al. (Thu,) studied this question.