Spontaneous regression of optic gliomas

Thirteen cases documented by serial neuroimaging

Cameron F. Parsa, Creig S. Hoyt, Robert L. Lesser, Joel M. Weinstein, Charles M. Strother, Rafael Muci-Mendoza, Marcos Ramella, Riri S. Manor, William A. Fletcher, Michael X Repka, James A. Garrity, Roberto N. Ebner, Mario L R Monteiro, Robert M. McFadzean, Irina V. Rubtsova, William F. Hoyt

Research output: Contribution to journalArticle

Abstract

Objective: To demonstrate spontaneous regression of large, clinically symptomatic optic pathway gliomas in patients with and without neurofibromatosis type 1 (NF-1). Methods: Patient cases were collected through surveys at 2 consecutive annual meetings of the North American Neuro-Ophthalmology Society (NANOS) and through requests on the NANOSNET Internet listserv. Serial documentation of tumor signal and size, using magnetic resonance imaging in 11 patients and computed tomography in 2 patients, was used to evaluate clinically symptomatic optic pathway gliomas. All tumors met radiologic criteria for the diagnosis ofglioma and 4 patients had biopsy confirmation of their tumors. In 3 patients, some attempt at therapy had been made many years before regression occurred. In one of these, radiation treatment had been given 19 years before tumor regression, while in another, chemotherapy had been administered 5 years before signal changes in the tumor. In the third patient, minimal surgical debulking was performed 1 year before the tumor began to shrink. Results: Spontaneous tumor shrinkage was noted in 12 patients. Eight patients did not have NF-1. In an additional patient without NF-1, a signal change within the tumor without associated shrinkage was detected. Tumor regression was associated with improvement in visual function in 10 of 13 patients, stability of function in 1, and deterioration in 2. Conclusions: Large, clinically symptomatic optic gliomas may undergo spontaneous regression. Regression was seen in patients with and without NF-1. Regression may manifest either as an overall shrinkage in tumor size, or as a signal change on magnetic resonance imaging. A variable degree of improvement in visual function may accompany regression. The possibility of spontaneous regression of an optic glioma should be considered in the planning of treatment of patients with these tumors.

Original languageEnglish (US)
Pages (from-to)516-529
Number of pages14
JournalArchives of Ophthalmology
Volume119
Issue number4
StatePublished - 2001

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Optic Nerve Glioma
Neuroimaging
Neurofibromatosis 1
Neoplasms
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Parsa, C. F., Hoyt, C. S., Lesser, R. L., Weinstein, J. M., Strother, C. M., Muci-Mendoza, R., ... Hoyt, W. F. (2001). Spontaneous regression of optic gliomas: Thirteen cases documented by serial neuroimaging. Archives of Ophthalmology, 119(4), 516-529.

Spontaneous regression of optic gliomas : Thirteen cases documented by serial neuroimaging. / Parsa, Cameron F.; Hoyt, Creig S.; Lesser, Robert L.; Weinstein, Joel M.; Strother, Charles M.; Muci-Mendoza, Rafael; Ramella, Marcos; Manor, Riri S.; Fletcher, William A.; Repka, Michael X; Garrity, James A.; Ebner, Roberto N.; Monteiro, Mario L R; McFadzean, Robert M.; Rubtsova, Irina V.; Hoyt, William F.

In: Archives of Ophthalmology, Vol. 119, No. 4, 2001, p. 516-529.

Research output: Contribution to journalArticle

Parsa, CF, Hoyt, CS, Lesser, RL, Weinstein, JM, Strother, CM, Muci-Mendoza, R, Ramella, M, Manor, RS, Fletcher, WA, Repka, MX, Garrity, JA, Ebner, RN, Monteiro, MLR, McFadzean, RM, Rubtsova, IV & Hoyt, WF 2001, 'Spontaneous regression of optic gliomas: Thirteen cases documented by serial neuroimaging', Archives of Ophthalmology, vol. 119, no. 4, pp. 516-529.
Parsa CF, Hoyt CS, Lesser RL, Weinstein JM, Strother CM, Muci-Mendoza R et al. Spontaneous regression of optic gliomas: Thirteen cases documented by serial neuroimaging. Archives of Ophthalmology. 2001;119(4):516-529.
Parsa, Cameron F. ; Hoyt, Creig S. ; Lesser, Robert L. ; Weinstein, Joel M. ; Strother, Charles M. ; Muci-Mendoza, Rafael ; Ramella, Marcos ; Manor, Riri S. ; Fletcher, William A. ; Repka, Michael X ; Garrity, James A. ; Ebner, Roberto N. ; Monteiro, Mario L R ; McFadzean, Robert M. ; Rubtsova, Irina V. ; Hoyt, William F. / Spontaneous regression of optic gliomas : Thirteen cases documented by serial neuroimaging. In: Archives of Ophthalmology. 2001 ; Vol. 119, No. 4. pp. 516-529.
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abstract = "Objective: To demonstrate spontaneous regression of large, clinically symptomatic optic pathway gliomas in patients with and without neurofibromatosis type 1 (NF-1). Methods: Patient cases were collected through surveys at 2 consecutive annual meetings of the North American Neuro-Ophthalmology Society (NANOS) and through requests on the NANOSNET Internet listserv. Serial documentation of tumor signal and size, using magnetic resonance imaging in 11 patients and computed tomography in 2 patients, was used to evaluate clinically symptomatic optic pathway gliomas. All tumors met radiologic criteria for the diagnosis ofglioma and 4 patients had biopsy confirmation of their tumors. In 3 patients, some attempt at therapy had been made many years before regression occurred. In one of these, radiation treatment had been given 19 years before tumor regression, while in another, chemotherapy had been administered 5 years before signal changes in the tumor. In the third patient, minimal surgical debulking was performed 1 year before the tumor began to shrink. Results: Spontaneous tumor shrinkage was noted in 12 patients. Eight patients did not have NF-1. In an additional patient without NF-1, a signal change within the tumor without associated shrinkage was detected. Tumor regression was associated with improvement in visual function in 10 of 13 patients, stability of function in 1, and deterioration in 2. Conclusions: Large, clinically symptomatic optic gliomas may undergo spontaneous regression. Regression was seen in patients with and without NF-1. Regression may manifest either as an overall shrinkage in tumor size, or as a signal change on magnetic resonance imaging. A variable degree of improvement in visual function may accompany regression. The possibility of spontaneous regression of an optic glioma should be considered in the planning of treatment of patients with these tumors.",
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AU - Parsa, Cameron F.

AU - Hoyt, Creig S.

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AU - Strother, Charles M.

AU - Muci-Mendoza, Rafael

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AU - Manor, Riri S.

AU - Fletcher, William A.

AU - Repka, Michael X

AU - Garrity, James A.

AU - Ebner, Roberto N.

AU - Monteiro, Mario L R

AU - McFadzean, Robert M.

AU - Rubtsova, Irina V.

AU - Hoyt, William F.

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N2 - Objective: To demonstrate spontaneous regression of large, clinically symptomatic optic pathway gliomas in patients with and without neurofibromatosis type 1 (NF-1). Methods: Patient cases were collected through surveys at 2 consecutive annual meetings of the North American Neuro-Ophthalmology Society (NANOS) and through requests on the NANOSNET Internet listserv. Serial documentation of tumor signal and size, using magnetic resonance imaging in 11 patients and computed tomography in 2 patients, was used to evaluate clinically symptomatic optic pathway gliomas. All tumors met radiologic criteria for the diagnosis ofglioma and 4 patients had biopsy confirmation of their tumors. In 3 patients, some attempt at therapy had been made many years before regression occurred. In one of these, radiation treatment had been given 19 years before tumor regression, while in another, chemotherapy had been administered 5 years before signal changes in the tumor. In the third patient, minimal surgical debulking was performed 1 year before the tumor began to shrink. Results: Spontaneous tumor shrinkage was noted in 12 patients. Eight patients did not have NF-1. In an additional patient without NF-1, a signal change within the tumor without associated shrinkage was detected. Tumor regression was associated with improvement in visual function in 10 of 13 patients, stability of function in 1, and deterioration in 2. Conclusions: Large, clinically symptomatic optic gliomas may undergo spontaneous regression. Regression was seen in patients with and without NF-1. Regression may manifest either as an overall shrinkage in tumor size, or as a signal change on magnetic resonance imaging. A variable degree of improvement in visual function may accompany regression. The possibility of spontaneous regression of an optic glioma should be considered in the planning of treatment of patients with these tumors.

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