Natural history of primary paediatric optic nerve sheath meningioma: case series and review

PurposeTo study the natural history, clinical and radiological characteristics of primary paediatric optic nerve sheath meningioma (PPONSM).MethodsRetrospective study of eight paediatric patients who were treated between 1994 and 2016 at the University Hospital Zurich, Switzerland and the Royal Adelaide Hospital, Australia. Clinical records and imaging studies were reviewed.ResultsThe mean age at presentation was 11 years (range: 6–17 years). There were six female patients and two male patients. 2/8 patients had associated neurofibromatosis type 2. Patients were followed up for 71–297 months (mean 156±70 months). 6/8 patients were observed through the course of their disease and 2/8 patients were treated with radiotherapy. 2/8 patients who were observed had minimal change in vision and did not experience tumour growth after long-term follow-up.ConclusionsThis is the largest PPONSM case series with long-term data on patients treated conservatively. We highlight that a small subset of these tumours are indolent and can be managed using observation alone.

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Long-term efficacy of fractionated conformal radiotherapy for the management of primary optic nerve sheath meningioma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313135 ◽

2018 ◽

Vol 103 (10) ◽

pp. 1436-1440 ◽

Cited By ~ 4

Author(s):

Ravi Pandit ◽

Liliana Paris ◽

Danielle S Rudich ◽

Robert L Lesser ◽

Mark J Kupersmith ◽

...

Keyword(s):

Visual Acuity ◽

Optic Nerve ◽

Symptom Onset ◽

Conformal Radiotherapy ◽

Optic Nerve Sheath ◽

Nerve Sheath ◽

Optic Nerve Sheath Meningioma ◽

The Mean

Background/AimFractionated conformal radiotherapy (FCRT) is now used to treat vision-threatening optic nerve sheath meningioma (ONSM), but long-term efficacy and safety data are lacking; the purpose of this study was to assess these key data.MethodsThis is a retrospective chart review with prospective follow-up of adult patients treated with FCRT for primary ONSM at four academic medical centres between 1995 and 2007 with ≥10 years of follow-up after treatment.Results16 patients were identified with a mean post-treatment follow-up of 14.6 years (range: 10.5–20.7 years). The mean age at symptom onset was 47.6 years (range: 36–60 years). FCRT was performed at a mean of 2.3 years after symptom onset (range: 0.2–14.0 years). At last follow-up, visual acuity had improved or stabilised in 14 of the 16 (88%) patients, and 11 (69%) had retained or achieved ≥20/40. The mean deviation on automated perimetry remained stable (−14.5 dB pretreatment vs −12.2 dB at last follow-up; p=0.68, n=10). Two (11%) patients had persistent pain, proptosis or diplopia, compared with six (38%) pretreatment (p=0.11). Two (13%) patients developed radiation retinopathy more than 6 months after completion of therapy, one (50%) of whom had worse visual acuity compared with pretreatment. No patient developed tumour involvement or radiation damage in the fellow eye.ConclusionFCRT stabilises or improves visual function in patients with primary ONSM and is associated with a low risk of significant ocular sequelae. This treatment should be considered instead of surgery in patients with primary ONSM who require intervention due to loss of visual sensory and/or ocular motor function.

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A long-term visual outcome comparison in patients with optic nerve sheath meningioma managed with observation, surgery, or surgery and radiotherapy.

Journal of Neuro-Ophthalmology ◽

10.1097/00041327-200303000-00023 ◽

2003 ◽

Vol 23 (1) ◽

pp. 93

Author(s):

Dilip A. Thomas

Keyword(s):

Optic Nerve ◽

Visual Outcome ◽

Optic Nerve Sheath ◽

Nerve Sheath ◽

Optic Nerve Sheath Meningioma ◽

Outcome Comparison

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A long-term visual outcome comparison in patients with optic nerve sheath meningioma managed with observation, surgery, radiotherapy, or surgery and radiotherapya aNo author has any commercial interest in any of the opinions expressed in this article.

Ophthalmology ◽

10.1016/s0161-6420(02)01017-5 ◽

2002 ◽

Vol 109 (5) ◽

pp. 890-899 ◽

Cited By ~ 157

Author(s):

Roger E Turbin ◽

Charlotte R Thompson ◽

John S Kennerdell ◽

Kimberly Peele Cockerham ◽

Mark J Kupersmith

Keyword(s):

Optic Nerve ◽

Visual Outcome ◽

Optic Nerve Sheath ◽

Nerve Sheath ◽

Commercial Interest ◽

Optic Nerve Sheath Meningioma ◽

Outcome Comparison

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Long-term results of Gamma Knife surgery for optic nerve sheath meningioma

Journal of Neurosurgery ◽

10.3171/2010.7.gks10869 ◽

2010 ◽

Vol 113 (Special_Supplement) ◽

pp. 28-33 ◽

Cited By ~ 11

Author(s):

Dong Liu ◽

Desheng Xu ◽

Zhiyuan Zhang ◽

Yipei Zhang ◽

Yanhe Li ◽

...

Keyword(s):

Optic Nerve ◽

Gamma Knife ◽

Gamma Knife Surgery ◽

Optic Nerve Sheath ◽

Long Term Results ◽

Nerve Sheath ◽

Optic Nerve Sheath Meningioma ◽

The Mean

Object The goal of this study was to assess the long-term results of Gamma Knife surgery (GKS) in patients harboring an optic nerve sheath meningioma (ONSM). Methods Thirty patients harboring an ONSM were treated with GKS between 1998 and 2003. Gamma Knife surgery was performed as the sole treatment option in 21 of these patients and resection had been performed previously in 9 patients. The mean volume of the tumor at the time of GKS was 3.6 cm3 (range 1.4–9.7 cm3), and the mean prescription peripheral dose was 13.3 Gy (range 10–17 Gy). The mean number of isocenters used to treat these lesions was 8 (range 5–14 isocenters). Results At a median follow-up of 56 months, visual acuity improved in 11 patients, remained stable in 13 patients (including 4 patients who were completely blind before GKS), and deteriorated in 6 patients. Follow-up images were available in all patients and showed tumor regression in 20 patients and stable tumor in 8 patients. Persistent imaging evidence of progression was only present in 2 patients. With the exception of reversible conjunctival edema in 4 cases, no other serious acute side effect was observed. Conclusions Gamma Knife surgery provides long-term tumor control for ONSM. The results of this study add substantial evidence that GKS may definitely become a standard treatment approach in selected cases of ONSM.

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