Optic pathway glioma

Abstract

Pediatric optic pathway gliomas share common clinicoradiographic characteristics and are typically World Health Organization grade I/II astrocytomas. Management of these tumors presents a therapeutic challenge based on host age as well as anatomic location. Radical excision is limited to tumors with unilateral optic nerve involvement and irretrievable ipsilateral vision loss. Subtotal resection is reserved for tissue diagnosis and acute symptom relief. Chemotherapy is infrequently curative but may effectively delay radiotherapy, allowing critical neurocognitive and neuroendocrine development in young children. For most lesions, radiotherapy offers the best option of local control but carries a range of risks related to adjacent normal tissue exposure.