Differential Diagnostic Challenges in Evaluation of Optic Nerve Glioblastoma with Extensive Spread to the Anterior Cranial Fossa

Objectives*
Optic nerve glioblastoma is an uncommon and highly aggressive type of tumor that can arise from the optic
nerve itself, the optic chiasm, or the optic tract. Due to its rarity and unusual location, the condition poses sig-
nificant diagnostic challenges. Neuroimaging typically reveals findings that lack specificity, often overlapping
with those of other optic nerve pathologies, which makes it difficult to establish a definitive diagnosis based
solely on imaging studies. As a result, histopathological confirmation through a biopsy becomes a critical step
in accurately identifying the disease. Early recognition and prompt initiation of treatment are essential because
any delay in therapeutic intervention can lead to a rapid progression of the tumor and substantially poorer sur-
vival outcomes for affected patients.
Materials and Methods
This case report is based on the clinical presentation, diagnostic evaluation, treatment approach, and follow-up
of a single patient diagnosed with optic nerve glioblastoma involving the optic chiasm. The patient’s medical
history, imaging studies, histopathological findings, and treatment outcomes were retrospectively reviewed and
analyzed.
Results
A 68-year-old woman with no significant medical history presented with exophthalmos, progressive visual de-
terioration, and partial vision loss. Diagnosis of optic nerve glioblastoma, IDH-wildtype, with optic chiasm in-
volvement was confirmed through radiological imaging and postoperative histopathological and histochemical
evaluation.
Conclusions
Glioblastoma involving the optic nerve is a rare occurrence scarcely reported in the literature. This case report
provides valuable insights into this uncommon manifestation, highlighting the diagnostic challenges posed by
its atypical presentation, which often mimics other optic nerve disorders. It emphasizes the critical role of
neuroradiology and histopathological evaluation in assessing progressively enlarging optic nerve lesions. By
expanding the limited knowledge on prognosis and therapeutic strategies for optic nerve glioblastomas, this
publication aims to guide future clinical efforts and improve patient care