Visual pathway tumor: A heterogeneous tumor with a variable clinical course

The aim of the study was to delineate the clinical characteristics of visua l pathway tumor in children without neurofibromatosis-I. The authors review ed the charts of all patients meeting these criteria (n = 12) who were foll owed in their center over a 13 year period. In 8 patients the disease was r elentlessly progressive and imaging showed a chiasmatic/hypothalamic, exoph ytic globular lesion. The remainder had a benign course with long periods o f tumor stability; one showed some spontaneous visual improvement. The lesi ons of the latter subgroup were multilobular with elongated posterior exten sion into the optic tract. This differentiation, according to the imaging f indings, may have significant therapeutic implications. In the first type, every effort should be made to arrest the disease and decrease the size of the lesion, whereas in the second despite decreased visual ability careful observation in the appropriate approach. There are as yet no Known biologic al markers to better delineate these two types of tumor behavior: