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NEUROLOGY 1996;46:1669-1673
© 1996 American Academy of Neurology

Gangliogliomas involving the optic chiasm

G. T. Liu, MD, S. L. Galetta, MD, L. B. Rorke, MD, L. T. Bilaniuk, MD, D. D. Vojta, MD, P. T. Molloy, MD, P. C. Phillips, MD, M. Needle, MD, A.-C. Duhaime, MD, L. N. Sutton, MD and N. J. Volpe, MD

From the Division of Neuro-ophthalmology (Drs. Liu, Galetta, and Volpe), Departments of Neurology and Ophthalmology, The Children's Hospital of Philadelphia, Hospital of the University of Pennsylvania, and Scheie Eye Institute; and the Divisions of Neuropathology (Dr. Rorke); Neuroradiology (Dr. Bilaniuk), Oncology (Dr. Vojta), Neuro-oncology (Drs. Molloy, Phillips, and Needle), and Neurosurgery (Drs. Duhaime and Sutton), The Children's Hospital of Philadelphia; University of Pennsylvania School of Medicine; Philadelphia, PA.
Received May 11, 1995. Accepted in final form September 25, 1995.
Address correspondence and reprint requests to Dr. Liu, Division of Neuro-ophthalmology, Dept. of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.

We report three patients with gangliogliomas involving the optic chiasm via distinct mechanisms.The ganglioglioma in one patient likely originated in the temporal lobe and spread medially to involve the chiasm, and diffuse spinal cord dissemination also occurred. Chiasmal involvement in this manner and dissemination at presentation are unusual for gangliogliomas. The tumor in a second patient was intrinsic to the hypothalmus and chiasm, while in the third patient, it involved both optic tracts, and a cyst compressed the chiasm laterally. Two patients developed severe bilateral visual loss, while the other had a stable bitemporal hemianopsia. Two patients received radiotherapy, but one continued to lose vision. Although gangliogliomas rarely involve chiasm, the mechanisms by which they produce chiasmal visual loss may be diverse, and the long-term visual prognosis is variable.

NEUROLOGY 1996;46: 1669-1673




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