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Malignant evolution of childhood chiasmal pilocytic astrocytoma

From the Neuro-ophthalmology Unit, Departments of Neurology, Neurological Surgery, Ophthalmology, and Pathology, University of California, San Francisco.

A 27-year-old obese mentally retarded woman showed progression of antisocial behavior with periodic somnolence 18 years after biopsy and irradiation of a large pilocytic astrocytoma of the chiasm and adjacent structures. Visual function, although impaired, had not changed during the long period of postoperative observation. Before she died, the tumor showed angiographic and histologic features of malignant glioma, but neuroradiologic and neuropathologic studies did not establish conclusively that it involved new areas of the brain. This report documents a rare case in which an irradiated childhood optic glioma underwent delayed malignant evolution.

Reprint requests should be addressed to Dr. Wilson, Division of Ophthalmology, Denver General Hospital, Denver, CO 80204.

Received for publication August 22, 1975.

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