Limits...
Optic nerve glioma: A great mimicker.

Bhaker P, Tyagi R, Mahajan D, Mohindra S, Vasishta RK - Surg Neurol Int (2014)

Bottom Line: A 27-year-old male presented with progressive, painless loss of vision in right eye, associated with vomiting and headache for one and a half months.A clinical impression of an intradural, optic nerve sheath meningioma was made.A clinical feedback, simple reticulin stain, and GFAP staining is of immense value in such cases to arrive at the correct diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT

Background: Arachnoid proliferation, although rare, is known to occur in association with optic gliomas. However, chondroid and chordoid metaplasia has not been reported previously.

Case description: A 27-year-old male presented with progressive, painless loss of vision in right eye, associated with vomiting and headache for one and a half months. Computed tomography (CT) scan revealed a contrast enhancing mass arising from planum sphenoidale. Perioperative findings showed the tumor adherent to the right optic nerve and attached to basal dura and falx. A clinical impression of an intradural, optic nerve sheath meningioma was made. Histopathological examination revealed a glial tumor with adjacent areas displaying marked fibroblastic and arachnoid cell proliferation with chondroid as well as chordoid differentiation along with myxoid change and dense collagenisation. Reticulin stain, immunochemistry with glial fibrillary acid protein (GFAP), epithelial membrane antigen (EMA), and S-100 helped to arrive at the final diagnosis of optic glioma displaying exuberant arachnoid proliferation with cartilaginous metaplasia.

Conclusion: We report a case of optic nerve glioma displaying extensive arachnoid proliferation, chordoid, and cartilaginous metaplasia, which mimicked chondrosarcoma or chordoid meningioma, posing a diagnostic dilemma. A clinical feedback, simple reticulin stain, and GFAP staining is of immense value in such cases to arrive at the correct diagnosis.

No MeSH data available.


Related in: MedlinePlus

MRI Brain shows a heterogeneously hyperintense mass extending from planum sphenoidale and compressing both frontal lobes on T2WI sagittal images (a) with surrounding edema. The lesion shows heterogeneous postcontrast enhancement and extends to the right frontal sinus and anterior cerebral artery on T1W1 image with contrast (b)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3927089&req=5

Figure 1: MRI Brain shows a heterogeneously hyperintense mass extending from planum sphenoidale and compressing both frontal lobes on T2WI sagittal images (a) with surrounding edema. The lesion shows heterogeneous postcontrast enhancement and extends to the right frontal sinus and anterior cerebral artery on T1W1 image with contrast (b)

Mentions: A 27-year-old male presented with progressive, painless loss of vision in right eye, associated with vomiting and headache for one and a half months, without accompanying loss of consciousness or fever. He had a history of seizures 4 years back, for which he was on antiepileptic drugs. On clinical examination, there was no perception of light in the right eye while left eye vision was normal. Computed tomography (CT) scan revealed a contrast enhancing mass arising from planum sphenoidale with mass effect [Figure 1]. The adjacent pituitary fossa and cavernous sinus were normal.


Optic nerve glioma: A great mimicker.

Bhaker P, Tyagi R, Mahajan D, Mohindra S, Vasishta RK - Surg Neurol Int (2014)

MRI Brain shows a heterogeneously hyperintense mass extending from planum sphenoidale and compressing both frontal lobes on T2WI sagittal images (a) with surrounding edema. The lesion shows heterogeneous postcontrast enhancement and extends to the right frontal sinus and anterior cerebral artery on T1W1 image with contrast (b)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927089&req=5

Figure 1: MRI Brain shows a heterogeneously hyperintense mass extending from planum sphenoidale and compressing both frontal lobes on T2WI sagittal images (a) with surrounding edema. The lesion shows heterogeneous postcontrast enhancement and extends to the right frontal sinus and anterior cerebral artery on T1W1 image with contrast (b)
Mentions: A 27-year-old male presented with progressive, painless loss of vision in right eye, associated with vomiting and headache for one and a half months, without accompanying loss of consciousness or fever. He had a history of seizures 4 years back, for which he was on antiepileptic drugs. On clinical examination, there was no perception of light in the right eye while left eye vision was normal. Computed tomography (CT) scan revealed a contrast enhancing mass arising from planum sphenoidale with mass effect [Figure 1]. The adjacent pituitary fossa and cavernous sinus were normal.

Bottom Line: A 27-year-old male presented with progressive, painless loss of vision in right eye, associated with vomiting and headache for one and a half months.A clinical impression of an intradural, optic nerve sheath meningioma was made.A clinical feedback, simple reticulin stain, and GFAP staining is of immense value in such cases to arrive at the correct diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

ABSTRACT

Background: Arachnoid proliferation, although rare, is known to occur in association with optic gliomas. However, chondroid and chordoid metaplasia has not been reported previously.

Case description: A 27-year-old male presented with progressive, painless loss of vision in right eye, associated with vomiting and headache for one and a half months. Computed tomography (CT) scan revealed a contrast enhancing mass arising from planum sphenoidale. Perioperative findings showed the tumor adherent to the right optic nerve and attached to basal dura and falx. A clinical impression of an intradural, optic nerve sheath meningioma was made. Histopathological examination revealed a glial tumor with adjacent areas displaying marked fibroblastic and arachnoid cell proliferation with chondroid as well as chordoid differentiation along with myxoid change and dense collagenisation. Reticulin stain, immunochemistry with glial fibrillary acid protein (GFAP), epithelial membrane antigen (EMA), and S-100 helped to arrive at the final diagnosis of optic glioma displaying exuberant arachnoid proliferation with cartilaginous metaplasia.

Conclusion: We report a case of optic nerve glioma displaying extensive arachnoid proliferation, chordoid, and cartilaginous metaplasia, which mimicked chondrosarcoma or chordoid meningioma, posing a diagnostic dilemma. A clinical feedback, simple reticulin stain, and GFAP staining is of immense value in such cases to arrive at the correct diagnosis.

No MeSH data available.


Related in: MedlinePlus