Optic nerve glioma presenting as a huge intrasellar mass. Case report.

We report the case of a twelve-year-old boy who presented with visual impairment and headache and was found to harbour a purely intrasellar cystic pilocytic astrocytoma originating from proximal left optic nerve. The mass was explored transcranially and decompression of the optic apparatus and subtotal resection of the cyst wall was accomplished. The patient received post-operative radiotherapy and stays symptom-free after two years. A review of the literature revealed six cases of optic pathway astrocytomas associated with cyst formation. Our case appears as the first case of an optic glioma to present as an intrasellar mass.