Optic Nerve Pilocytic Astrocytoma in a Pediatric Patient: A Case Report

Authors

  • I Made Stepanus Biondi Pramantara Neurosurgery Residency Program, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia
  • I Wayan Niryana Neurosurgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Indonesia
  • Agung Bagus Sista Sista Satyarsa Neurosurgery Division, Department of Surgery, Faculty of Medicine Universitas Udayana – Prof. Dr. I.G.N.G. Ngoerah General Hospital Bali
  • Nyoman Golden Neurosurgery Division, Department of Surgery, Faculty of Medicine Universitas Udayana – Prof. Dr. I.G.N.G. Ngoerah General Hospital Bali
  • Tjokorda Gede Bagus Mahadewa Neurosurgery Division, Department of Surgery, Faculty of Medicine Universitas Udayana – Prof. Dr. I.G.N.G. Ngoerah General Hospital Bali
  • Sri Maliawan Neurosurgery Division, Department of Surgery, Faculty of Medicine Universitas Udayana – Prof. Dr. I.G.N.G. Ngoerah General Hospital Bali
  • I Putu Pramana Suarjaya Department of Anesthesiology and Intensive Therapy, Faculty of Medicine Universitas Udayana–Prof. Dr. IGNG Ngoerah Hospital Bali

DOI:

https://doi.org/10.24244/jni.v13i3.594

Keywords:

Optic nerve pilocytic astrocytoma, surgical intervention, visual loss

Abstract

Pilocytic astrocytoma is a type of low-grade glioma that can develop in any part of the central nervous system. It primarily affects individuals in the pediatric and young adult age groups. Optic nerve pilocytic astrocytoma is an uncommon, gradually developing type of brain tumor known as a glioma. It is categorized as a grade I tumor by the World Health Organization (WHO). We aim to report rare optic nerve pilocytic astrocytomas and discuss their clinical findings and interconnection with the current literature. A 7-year-old male patient exhibited left-sided eye proptosis and complete loss of vision. A magnetic resonance imaging (MRI) performed before surgery showed the presence of a tumor in the left eye socket. The mass has a spherical shape and smooth boundaries, resulting in the compression of the left optic tract from behind. The left optic tract appears darker on T1-weighted images and brighter on T2-weighted images. On contrast administration, there is heterogenous contrast enhancement. A total resection of the mass was performed. Histopathology results show pilocytic astrocytoma (WHO Grade I). Optic nerve pilocytic astrocytoma is a tumor that can affect the optic nerve pathway. Early diagnosis and multidisciplinary team management are required. Treatment must be individualized, and the options include chemotherapy, radiotherapy, and surgical intervention. Surgery is only recommended in cases of painful or disfiguring proptosis and exposure keratopathy in eyes with severe vision impairment.

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References

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Published

2024-10-23

Issue

Vol. 13 No. 3 (2024)

Section

Case Report

License

Authors retain copyright and grant Jurnal Neuroanestesi Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License that allows others to freely share and remix the work with an acknowledgement of the work's authorship and initial publication in Jurnal Neuroanestesi Indonesia

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