| Identifier |
walsh_2021_s1_c3-slides |
| Title |
X' Marks the Spot |
| Creator |
Luis Andre Leal Ferman; Leslie Bruch; John Buatti; Jeremy Greenlee |
| Affiliation |
(LALF) (LB) (JB) (JG) University of Iowa, Iowa City, Iowa |
| Subject |
Optic Chiasm; Intracranial Tumors; Magnetic Resonance Imaging (MRI); Vision Loss Binocular |
| History |
This 24 year-old man presented with several months of progressive visual loss in both eyes. His past medical, surgical and ocular history was unremarkable. There was no family history of phacomatosis. He complained of occasional binocular diplopia, but denied headaches or any other neurological symptoms. He denied galactorrhea, fatigue, and abdominal pain. On exam, his visual acuity was 20/125 OD and 20/50 OS. He had incomplete atypical bitemporal defects that respected the vertical meridian and pallor of both optic nerves, right more than left. Magnetic resonance imaging (MRI) of the brain showed an enlarged optic chiasm and a hyperintense left frontal periventricular lesion that was abutting the genu of the corpus callosum. Both lesions showed mild contrast enhancement. The differential diagnosis included a primary intrinsic chiasmal glioma versus an inflammatory etiology. An extensive infectious, inflammatory, and rheumatologic work-up was unrevealing. Cerebrospinal fluid (CSF) evaluation showed a mild lymphocytic pleocytosis (11/mL) and mildly increased protein concentration (54 mg/dL). The CSF showed 3 oligoclonal bands. CSF cytology and cultures were negative. Based on these findings, he received a 1-month course of high dose steroid treatment without clinical improvement and further visual loss in both eyes. Repeat MRI brain showed no radiological improvement. At this point, the patient started complaining of increased thirst. A diagnostic procedure was performed. |
| Disease/Diagnosis |
Primary intrinsic chiasmal germinoma. |
| Date |
2021-02 |
| References |
1) Krolak-Salmon, Adrodias, Honnorat, Caudie Bret et al, Beware of optic neuritis!, The Lancet, vol1, 2002. 2) Chaudry, Ahmad, Whittington, Schatz, Morcos, Primary Intrinsic Chiasmal Germinoma, Journal of Neuro-Ophthalmology, 35, 171-174,2015. 3) Akiyama, Suzuki, Mikuni, Germinoma Mimicking Tumefactive Demyelinating Disease in Pediatric Patients, Pediatr Neurosurg, 2016. 4) Bowman, Bradley, Primary Chiasmal Germinoma, Journal of Clinical Neuro-Ophthalmology, 10, 9-17, 1990. |
| Language |
eng |
| Format |
application/pdf |
| Format Creation |
Microsoft PowerPoint |
| Type |
Text |
| Source |
53rd Annual Frank Walsh Society Meeting |
| Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2021 |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Walsh Session Annual Meeting Archives: https://novel.utah.edu/Walsh/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2021. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6c8883c |
| Setname |
ehsl_novel_fbw |
| ID |
1694316 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6c8883c |
