Optic nerve glioma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Optic nerve glioma must be differentiated from other diseases that cause optic nerve enlargement and tumors located at optic chiasm, such as optic nerve meningioma, orbital pseudotumor, optic neuritis, orbital lymphomas, metastasis, fibrous dysplasia, paranasal mucocele, Lymphoma, rhabdomyosarcoma, neurofibromatosis, perioptic haemorrhage, erdheim-Chester disease, juvenile xanthogranuloma, medulloepithelioma, retinoblastoma, krabbe disease, optic nerve and chiasm glioma such as germinoma and sarcoidosis, and optic chiasm glioma extending into the hypothalamus such as pituitary adenoma, craniopharyngioma, malignant astrocytoma, dermoid cyst, chordoma, colloid cyst, fibrous dyplasia, sarcoidosis, histiocytosis X, tuberculous granuloma, and hemangloendothelioma.

Differential diagnosis

The main differential is that of optic nerve meningioma however the potential list is much longer including most causes of optic nerve enlargement. Absence of calcification can be used to differentiate optic nerve glioma from optic nerve sheath meningioma. Additionally, when the bulk of the tumor is located at the chiasm, the differential should include pituitary region masses. The differential diagnosis of optic nerve glioma include:

• Optic nerve meningioma
• Orbital pseudotumor
• Optic neuritis
• Orbital lymphoma
• Metastases(Neuroblastoma, Leukemia, Ewing's sarcoma)
• Fibrous dysplasia
• Paranasal mucocele
• Hemangioma
• Lymphoma
• Rhabdomyosarcoma
• Neurofibromatosis
• Perioptic haemorrhage
• Erdheim-Chester disease
• Juvenile xanthogranuloma
• Medulloepithelioma
• Retinoblastoma
• Krabbe disease
• Optic nerve and chiasm glioma:
  • Germinoma
  • Sarcoidosis
• Optic chiasm glioma extending into the hypothalamus:
  • Pituitary adenoma
  • Craniopharyngioma
  • Malignant astrocytoma
  • Dermoid cyst
  • Chordoma
  • Colloid cyst
  • Fibrous dyplasia
  • Sarcoidosis
  • Histiocytosis X
  • Tuberculous granuloma
  • Hemangloendothelioma