Optic glioma

Summary:

Case Capsule: Age: 21/2 yrs Optic glioma, dimination of vision on one side Case disscussed by Neurosurgeon on phone/no surgical intervention My opinion was: to wait at least 6mths (should we wait for completion of 3yrs) Nsx:what we will do if it progresses on other side meanwhile. Regards! Dr.Shailesh S. Shende MBBS, MD (Radiation Oncology) Consultant Radiation Oncologist, Vimal Lalchand Mutha Cancer Centre, Deenanath Mangeshkar Hospital & Research Center, Erandwane, Pune-411004 Phone no - [phone], Extn 2910 Fax - [phone] Mobile No - 09890609830 Email - [e-mail]

Optic glioma

Shailesh shende 19 Jan 2011 12:11

Greetings from Pune!
To opine on the following case.

Case Capsule:
Age: 21/2 yrs
Optic glioma, dimination of vision on one side
Case disscussed by Neurosurgeon on phone/no surgical intervention
My opinion was: to wait at least 6mths (should we wait for completion of 3yrs)
Nsx:what we will do if it progresses on other side meanwhile.

Regards!

Dr.Shailesh S. Shende

MBBS, MD (Radiation Oncology)

Consultant Radiation Oncologist,

Vimal Lalchand Mutha Cancer Centre,

Deenanath Mangeshkar Hospital & Research Center,

Erandwane, Pune-411004

Phone no - [phone], Extn 2910

Fax - [phone]

Mobile No - 09890609830
Email - oc.liamffider|ednehshseliahs#oc.liamffider|ednehshseliahs

Re: Optic glioma

Nikhilesh Patil 19 Jan 2011 16:39

Hi Shailesh,
Unfortunate child, What is the exact location of the tumor? Size? NF-1 ?
You may want to read http://www.ncbi.nlm.nih.gov/pubmed/21121786, http://www.ncbi.nlm.nih.gov/pubmed/20979170 , http://www.ncbi.nlm.nih.gov/pubmed/20451859
Interesting debate: http://www.ncbi.nlm.nih.gov/pubmed/20577275 and http://www.ncbi.nlm.nih.gov/pubmed/20577270
This paper says chemo should be offered first http://www.ncbi.nlm.nih.gov/pubmed/20303553
I dont have any experience in this area and will urge other members to pitch in.
Nikhilesh

Last edited on 19 Jan 2011 16:52 by Nikhilesh Patil Show more

Re: Optic glioma

Santam Chakraborty 20 Jan 2011 06:00

Hi Sailesh,
There is an interesting article in oncopedia available on this topic at http://www.cure4kids.org/ums/oncopedia/case_detail/chapter/?id=15.
The main points are:

1. ONG restricted to orbit without significant progression on imaging willl not require treatment in most cases and will regress sometimes without treatment
2. ONG with chiasmal involvement, suprasellar involvement, diencephalic syndrome and rapidly progressive visual loss do require treatment
3. RT is the treatment of choice but reserved for those aged > 8 -10 years to avoid the risks of SMN/ Neurocognitive/ cerebrovascular/ skeletal abnormalities in long term f/u
4. CCT is recommended to restrict the growth of tumor till RT can be given safely
5. CCT utilises Carboplatin/vincristine/etoposide in most protocols.
6. You can expect CCT will stabilize the leison in 60% over a 3 year time span but about 21% will progress during CCT
7. RT however has the best PFS rates approaching 90% at 10 years.
8. If the child has NF1 then the prognosis is better - so testing for same can be useful for prognostication.

Overall I think a close follow up with radiological and visual field testing is mandated provided the parents understand that no treatment is not a free ticket to come back 10 years with a proptosed eye.

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Re: Optic glioma

Nikhilesh Patil 21 Jan 2011 22:26

Shailesh, please do let us know what you decide to do.
thanks
nikhilesh

Last edited on 21 Jan 2011 22:26 by Nikhilesh Patil Show more