Abstract

BackgroundMalignant optic gliomas are rare, but they rapidly become lethal visual pathway tumors. We present the clinical course, treatment, and prognosis of a case of unilateral malignant optic glioma in a young man with a history of brain glioblastoma multiforme (GBM).Case presentationA 21-year-old man, who had GBM 7 years ago complained of a transient shadow in his vision and presented with normal visual acuity but optic disc edema and an enlarged blind spot in the right eye (oculus dexter, OD). Magnetic resonance imaging (MRI) showed a right intraorbital optic nerve tumor without a brain lesion. Chiasm involvement and severe vision deterioration occurred 3 months later. A biopsy of the right optic nerve revealed glioblastoma. Concurrent chemoradiotherapy (CCRT) prevented involvement of the fellow eye 1 year after symptom onset.ConclusionThis report demonstrated that a regular ocular exam should be recommended for several years after GBM. In young healthy patients who are able to undergo chemotherapy and radiotherapy, visual function in the fellow eye can be preserved.

Highlights

  • Malignant optic gliomas are rare, but they rapidly become lethal visual pathway tumors

  • We report a young man presenting with unilateral malignant optic glioma after having glioblastoma multiforme (GBM) for >5 years

  • A follow-up orbital Magnetic resonance imaging (MRI) showed progressive changes in the right optic nerve lesion involving the chiasm on a T1- weighted image (Modified Dodge classification : 2cR) [9] (Fig. 2h, i)

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Summary

Conclusion

This report demonstrated that a regular ocular exam should be recommended for several years after GBM.

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