Fact-sheet: Optic pathway glioma


Updated on 03/20/2023 at 10:09 AM

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Definition

Relatively rare tumor, the majority of which are pilocytic astrocytomas, most often occurring in the setting of neurofibromatosis type 1

CT

  • Enlargement of the optic nerve, fusiform or exophytic
  • Enlargement of the optic canal
  • Possible optic nerve elongation (kinking or angulation)

MRI

Contrast-enhanced orbital MRI:

  • Enlargement of the optic nerve
  • T1 hypointense, or T1 isointense
  • Central T2 hyperintensity, with a thin peripheral T2 hypointense rim corresponding to the dura mater
  • Variable enhancement after contrast administration

Classification

Dodge classification:

  • Stage 1: involves only the optic nerve
  • Stage 2: involvement of the optic chiasm
  • Stage 3: hypothalamic and/or adjacent structure involvement

Differential diagnosis

  • Optic nerve sheath meningioma
  • Mass of the pituitary region