| Identifier |
walsh_2015_s1_c4-2 |
| Title |
Shady Double Crosser |
| Creator |
Francine Wein |
| Affiliation |
McGill University Montreal, QC, Canada |
| Subject |
Photophobia; Diplopia; Metastasis; Skull Base |
| History |
A 62-year-old woman presented with a one-month history of severe light sensitivity and headache, and atwo week history of diplopia. Her photophobia was severe enough for her to wear sunglasses indoors.Her past medical history was significant for a cholecystectomy and Crohns disease, for which she hadundergone a partial colectomy. Her only medication was ranitidine. Review of systems wasunremarkable. Neuro-ophthalmic examination revealed visual acuity of 20/20 OU. She had normalanterior segments, pupillary reactions, and fundi OU. Motility assessment showed an isolated leftabduction deficit. The fifth and seventh cranial nerves were intact. There was no ptosis, proptosis, ornystagmus. CT scan of the brain revealed a 3.6 x 2.4 cm lesion centered on the left skull base. Itextended to and filled most of the sphenoid sinus. There was bony destruction, with completedestruction of the petrous apex. The mass also broke through the clivus to extend into the premedullarycistern. There were areas of hyperdensity within the mass. MRI showed a large lesion of the left clivusand petrous bone. It was hyperintense on TI and enhanced homogeneously with gadolinium. The masswas shown to extend to the lower aspect of the sella. The patient underwent a metastatic workup. Herblood work was significant for an elevated alkaline phosphatase of 155 and a carcinoembryonic antigenof 61.6. CT of the chest was unremarkable. Abdominal CT showed several hypodense liver lesions,suggesting metastases. A 2.5 x 2.1 cm hypodense mass was present in the pancreatic tail. CA19-9, aserum marker for pancreatic cancer, was less than one. A diagnostic study was performed. |
| Disease/Diagnosis |
Pancreatic adenocarcinoma metastatic to the skull base |
| Date |
2015-02 |
| References |
1. Park KS, Kim M, Park SH, Lee KW. Nervous system involvement by pancreatic cancer. J Neurooncol63:313-316, 2003. 2. Lemke J et al. Brain metastasis in pancreatic cancer. Int J Mol Sci 14:4163-4173, 2013 |
| Language |
eng |
| Format |
application/pdf |
| Format Creation |
Microsoft PowerPoint |
| Type |
Text |
| Source |
47th Annual Frank Walsh Society Meeting |
| Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2015 |
| 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 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6rr4vv0 |
| Setname |
ehsl_novel_fbw |
| ID |
179300 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6rr4vv0 |
