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17 Y/O with Behavioral Changes

The patient had no visual sx’s. This is not a dedicated orbit exam, but an isolated L optic nerve glioma/hamartoma is visible and does not enhance.  When isolated to the nerve in NF1, these lesions are often asx, usu do not grow and occasionally even shrink.  Even enhancement can resolve over time and does not portend malignancy.  Extension into the optic radiations is associated with dedifferentiation into malignancy.