Hemangioblastoma of the optic nerve

Optic nerve hemangioblastoma is a rare tumor that is usually unilateral and most commonly occurs in the context of von Hippel-Lindau disease. Differential diagnosis is based on clinical history and imaging. Magnetic resonance imaging with gadolinium enhancement is the most useful imaging modality as...

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Bibliographic Details
Published in:Survey of ophthalmology 2019-03, Vol.64 (2), p.175-184
Main Authors: McGrath, Lindsay A., Mudhar, Hardeep Singh, Salvi, Sachin M.
Format: Article
Language:English
Subjects:
Diagnosis, Differential
hemangioblastoma
Hemangioblastoma - diagnosis
hemangioma
Humans
Magnetic Resonance Imaging
optic nerve
Optic Nerve Neoplasms - diagnosis
tumor
von Hippel-Lindau
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Summary:Optic nerve hemangioblastoma is a rare tumor that is usually unilateral and most commonly occurs in the context of von Hippel-Lindau disease. Differential diagnosis is based on clinical history and imaging. Magnetic resonance imaging with gadolinium enhancement is the most useful imaging modality as it can reveal flow voids and an absence of dural attachment, differentiating optic nerve hemangioblastoma from other more commonly encountered optic nerve tumors. Optic nerve hemangioblastoma are usually well-circumscribed vascular lesions composed of stromal cells and vascular endothelial cells. These lesions are diagnosed at a mean age of 37 years and can be asymptomatic, but over time, patients may develop reduction in vision, proptosis, and pain. Surgical excision is well described via orbital, transsphenoidal, or transcranial approaches. Given the risks associated with surgery, a stepwise conservative approach is advocated by most clinicians in the absence of severe symptoms. Although uncommon, this optic nerve tumor should be considered in young patients presenting with pain, proptosis, and optic nerve pallor, with or without a history of von Hippel-Lindau disease.
ISSN:0039-6257
1879-3304
DOI:10.1016/j.survophthal.2018.10.002