Optic Nerve Glioma
6 years old, female
Last year patient was diagnosed with neurofibromatosis type 1. During her first bianual specialist team follow-up, a slight headache was reported. It was monitored, and had increased severly by her second bianual check-up.
After some tests, there is a suspected growth of the tumor.
The following symptoms were reported:
Severe headache, balance problems, involuntary eye movements and daytime sleepiness.
Tests carried out -
Brain CT scan, biopsy, and retinography images were taken.Spinal MR.
Question: I read about a case of a malignant optic nerve glioma that metastasized to the spinal cord, however it occured in women of 60+ age. Could you confirm you do not find any abnormalities in the spine images, and suggest the likelyhood of this tumor actually metastasizing?
16 Oct 2014 14:59
Did you notice anything abnormal in the biopsy that could suggest potential for metastasis?
16 Oct 2014 15:07
If her vision is not impaired, I would wait to see if the tumor spontaneously regresses, as usually happens in these types of cases. I do not notice any abnormalities in the spinal images. By the way, the Scout lines in the MedViewer were very helpful to check this! I would just keep monitoring, perhaps monthly, to observe the pace of the tumor growth. Inbox me or leave a comment if you have any further questions.
16 Oct 2014 15:11
Hi Dr Karev,
I'm a pathologist working with Dr Stevens. I would like to ask you if you could explain to me how you viewed the lumbar MR images with Scout lines?
16 Oct 2014 15:18
Sure thing! I opened the "Lumbar" study, then the "SagT2.." series, and I right-clicked on the image and selected the "Two Viewports (side-by-side 1x2)" option. It's great, it shows you exactly what section of the spine you are looking at.
16 Oct 2014 15:20
Thank you both. Dr Hunt, biopsies came back as expected. Dr Karev, thank you for your confirmation. I will keep an eye out for any optical disc variations or disc swelling due to tumor growth.