title: Transtentorial dissemination of optic nerve glioblastoma: case report.
abstract: Optic nerve glioblastoma is a rare entity that usually presents with rapidly progressive vision loss, which eventually results in blindness and, ultimately, death. As with malignant gliomas in other anatomical locations, local recurrence is common. Isolated rapid changes in vision, atypical neuroimaging findings, and the rarity of optic nerve glioblastoma may render diagnosis challenging and, thus, delay treatment. The authors present a case of optic nerve glioblastoma that was treated with subtotal resection followed by adjuvant radiation therapy and temozolomide. One year following the initial diagnosis, the patient developed a right cerebellar lesion, which was histopathologically consistent with glioblastoma. This case represents the first report of transtentorial dissemination of an optic nerve glioblastoma. In addition, the authors reviewed the literature regarding optic nerve glioblastomas. Of the 73 previously reported cases of malignant optic nerve gliomas, 32 were histologically confirmed glioblastomas. The mean age at diagnosis was 62 years, and 56% were male; the median survival was 7 months. A malignant glioma of the optic nerve should be considered in the differential diagnosis of a patient with rapidly progressive visual loss. However, the incidence of optic nerve glioblastoma is exceedingly low.
authors.affiliation: 1Department of Neurological Surgery and.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Mastorakos
authors.affiliation: 2Division of Neuropathology, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Hays
authors.affiliation: 1Department of Neurological Surgery and.
authors.forename: James P
authors.initials: JP
authors.lastname: Caruso
authors.affiliation: 1Department of Neurological Surgery and.
authors.forename: Ching-Jen
authors.initials: CJ
authors.lastname: Chen
authors.affiliation: 1Department of Neurological Surgery and.
authors.forename: Dale
authors.initials: D
authors.lastname: Ding
authors.affiliation: 1Department of Neurological Surgery and.
authors.forename: Davis G
authors.initials: DG
authors.lastname: Taylor
authors.affiliation: 1Department of Neurological Surgery and.|2Division of Neuropathology, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: M
authors.initials: M
authors.lastname: Beatriz Lopes
authors.affiliation: 1Department of Neurological Surgery and.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Shaffrey
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005909:Glioblastoma / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D020339:Optic Nerve Glioma / Q000150:complications / Q000473:pathology* / Q000628:therapy*; D019574:Optic Nerve Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy*; D012086:Reoperation; D000077204:Temozolomide / Q000627:therapeutic use; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology
chemical_list: D018906:Antineoplastic Agents, Alkylating; D000077204:Temozolomide
keywords: MONG = malignant optic nerve glioma; case report; glioblastoma; oncology; optic nerve; review