Optic pathway gliomas in adults

Neurosurgery. 2014 Mar;74(3):273-9; discussion 279-80. doi: 10.1227/NEU.0000000000000257.

Abstract

Background: Optic pathway gliomas (OPGs) are considered relatively benign pediatric tumors. Adult patients with OPG can be divided into 2 groups: adult patients with tumors diagnosed in childhood and adult patients diagnosed during adulthood.

Objective: To characterize the clinical course of adult patients with OPG.

Methods: We retrospectively collected clinical and imaging data of all adult OPG patients monitored in our medical center between 1990 and 2012.

Results: Twenty-two adult patients were included. Age at diagnosis varied widely (6 months-66 years), as did age at last follow-up (18-74 years). Ten patients were diagnosed at adulthood and 12 in childhood. Of the patients diagnosed at childhood, 6 had radiological progression during childhood, and 3 of those patients suffered visual impairment. From this group, 1 patient had further progression during adulthood accompanied by additional visual decline, and 2 patients had additional visual decline during adulthood despite no signs of progression. Of the 6 patients whose tumors were stable during childhood, all 6 remained stable during adulthood. Of 10 patients diagnosed at adulthood, 6 patients suffered visual deterioration; in 5 of them, a concomitant progression was noted. Two patients were diagnosed with high-grade gliomas.

Conclusion: OPGs may be active during childhood or adulthood. Those patients who experienced anatomic activity during childhood are prone to continue experiencing active disease during adulthood. A significant percentage of patients diagnosed with low-grade OPG at adulthood may suffer progression, visual decline, or both.

Abbreviations: NF1, neurofibromatosis 1OPG, optic pathway gliomas.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Optic Nerve Glioma / diagnosis*
  • Optic Nerve Glioma / therapy*
  • Optic Nerve Neoplasms / diagnosis*
  • Optic Nerve Neoplasms / therapy*
  • Retrospective Studies
  • Young Adult