Optic Pathway Glioma

FACTS

  • 5% of primary intracranial pediatric tumors
  • can occur with NF1 (more indolent) or sporadically (more aggressive)
  • generally benign

    HPI

    visual disturbances
    endocrinopathy
    obstructive hydro sx

    PHYSICAL EXAM

    IMAGING

    Hydro: evaluate for intra-ventricular/exophytic extensions of tumor
    Enhancement is important prognostic information (non-enhancing typically do not progress)
    A/P
    Observation
    Treatment indicated if progressing/deficits
    1. Chemo: generally first line vincristine/carboplatin
    1. Surgery: de-bulking can be appropriate, but GTR is very morbid (blindness)
    1. Radiation: also very morbid, generally avoided