A Rare Entity: Two Cases of Optic Nerve Glioma in Adults

Öz

Optic nerve gliomas are rare tumors that constitute the majority of optic pathway tumors and generally occur in the first two decades. They can seen anywhere along the optic pathway, with the optic nerve and chiasm being common sites. Most optic nerve gliomas are histologically classified as pilocytic astrocytomas, often associated with neurofibromatosis type 1. While typically presenting with visual impairment, other symptoms like optic atrophy and proptosis may also occur. Here, we report two cases of optic nerve glioma in elderly females aged 65 and 79 years, presenting with ocular pain and vision loss. Radiological and histopathological findings showed characteristic features of low-grade glioma. Immunohistochemical staining supported the diagnosis. We found 2 cases worth presenting because of the presence of prolonged symptoms and the advanced age of the patients.

Anahtar Kelimeler

• optic nerve
• optic nerve glioma
• pilocytic astrocytoma

Nadir Bir Durum: Yetişkinlerde 2 Optik Sinir Gliomu Olgusu

Öz

Optik sinir gliomları, optik yolak tümorlerinin çoğunluğunu oluşturan genellikle hayatın ilk 2 yılında görülen nadir tümörlerdir. En sık optik sinirde olmakla beraber optik yolak boyunca yerleşebilir. Çoğu optik sinir gliomaları, genellikle nörofibromatozis tip 1 ile ilişkilendirilen pilositik astrositomalar olarak sınıflandırılmaktadır. Başlıca görme bozukluğu olmakla beraber optik atrofi ve proptoz gibi belirtiler de görülebilir. 65 ve 79 yaşında, sırasıyla göz ağrısı ve görme kaybı ile başvuran 2 kadın hastaya ait iki optik sinir glioma vakasını rapor ediyoruz. Radyolojik ve histopatolojik bulgular, düşük dereceli gliomun karakteristik özelliklerini göstermekle beraber immünohistokimyasal boyama da tanıyı desteklemiştir. Uzun süreli semptomların varlığı ve hastaların ileri yaşta olması sebebiyle 2 vakayı sunmaya değer bulduk.

Anahtar Kelimeler

• optik sinir
• optik sinir gliomu
• pilositik astrositoma

Kaynakça

1. Burkhard C., Di Patre PL., Schüler D., et al. A population- based study of the incidence and survival rates in patients with pilocytic astrocytoma. J Neurosurg 2003; 98(6):1170-4. Doi: 10.3171/ jns.2003.98.6.1170.
2. Binning MJ., Liu JK., Kestle JR., Brockmeyer DL., Walker ML. Optic pathway gliomas: a review. Neurosurg Focus 2007; 23(5):E2. Doi: 10.3171/ FOC-07/11/E2.
3. Kuramitsu S., Suzaki N., Takahashi T., et al. Pilocytic astrocytoma of the optic nerve with intracystic hemorrhage in an adult: illustrative case. J Neurosurg Case Lessons 2022; 4(2):CASE22143. Doi: 10.3171/CASE22143.
4. Huang M., Patel J., Patel BC. Optic Nerve Glioma. In: StatPearls [Internet]. Treasure Island, FL: Stat- Pearls Publishing; 2024. Available from: https:// www.ncbi.nlm.nih.gov/books/NBK557878/
5. Shields JA., Bakewell B., Augsburger JJ., Flanagan JC. Classification and incidence of space-occupying lesions of the orbit. Arch Ophthalmol 1984; 102(11):1606-11. Doi: 10.1001/archopht. 1984.01040031296011.
6. Farazdaghi MK., Katowitz WR., Avery RA. Current treatment of optic nerve gliomas. Curr Opin Ophthalmol 2019; 30(5):356-63. Doi: 10.1097/ ICU.0000000000000587.
7. Cummings TJ., Provenzale JM., Hunter SB., et al. Gliomas of the optic nerve: histological, immunohistochemical (MIB-1 and p53), and MRI analysis. Acta Neuropathol 2000; 99(5):563-70. Doi: 10.1007/s004010051161.
8. Campbell AA., Gartrell-Corrado RD., Mansukhani M., et al. SETD2 mutation in an aggressive optic nerve glioma. JAMA Ophthalmol 2020; 138(1):102-4. Doi: 10.1001/jamaophthalmol. 2019.4511.

9. Bilgin G., Al-Obailan M., Bonelli L., et al. Aggressive low-grade optic nerve glioma in adults. Neuroophthalmology 2014; 38(6):297-309. Doi: 10.3109/01658107.2014.966851.
10. Mishra MV., Andrews DW., Glass J., et al. Characterization and outcomes of optic nerve gliomas: a population-based analysis. J Neurooncol 2012; 107(3):591-7. Doi: 10.1007/s11060-011-0783-2.
11. van Baarsen K., Roth J., Serova N., et al. Optic pathway-hypothalamic glioma hemorrhage: a series of 9 patients and review of the literature. J Neurosurg 2018; 129(6):1407-15. Doi: 10.3171/2017.8.JNS163085. Volume: 5 - Issue: 1 Nisan|April 2025 41 Kurt et al.
12. Grossniklaus HE., Eberhart CG., Kivelä TT. WHO Classification of Tumours of the Eye. 4th ed. Lyon: International Agency for Research on Cancer; 2018.
13. Hill CS., Khan M., Phipps K., et al. Neurosurgical experience of managing optic pathway gliomas. Childs Nerv Syst 2021; 37(6):1917-29. Doi: 10.1007/s00381-021-05060-8.
14. Thomas RP., Gibbs IC., Xu LW., Recht L. Treatment options for optic pathway gliomas. Curr Treat Options Neurol 2015; 17(2):333. Doi: 10.1007/ s11940-014-0333-2.
15. Tang Y., Gutmann DH. Neurofibromatosis type 1-associated optic pathway gliomas: current challenges and future prospects. Cancer Manag Res 2023; 15:667-81. Doi: 10.2147/CMAR. S362678.