Not All Men With Thick Skulls Have High Testosterone (Video)

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Identifier walsh_2020_s2_c1
Title Not All Men With Thick Skulls Have High Testosterone (Video)
Creator Prem Subramanian
Affiliation (PS) Sue Anschutz-Rodgers UCHealth Eye Institute/Univ of Colorado School of Medicine, Aurora, Colorado
Subject Orbital Inflammation, Optic Disc Edema
History A 54-year-old retired USAF fighter pilot was referred in Aug 2016 for evaluation of possible bilateral optic disc swelling noted on routine optometric examination. His past medical history included low testosterone discovered 2 years prior in the context of fatigue and exercise intolerance. MRI brain at that time as well as serologic investigations for other hormonal abnormalities were normal by report, and he was using topical testosterone gel for replacement. Initial ophthalmologic exam showed normal visual acuity, color vision, and Humphrey visual fields. On fundus exam, both optic nerves were elevated without obvious swelling, fluorescein angiography showed no leakage, and OCT of the RNFL was normal in both eyes. The patient returned for surveillance in 3 months, at which time visual function remained normal but peripapillary hemorrhage was noted in the right eye. FA now had disc leakage OD. CT orbits (Fig 1) showed an ill-defined bilateral orbital process as well as diffuse bony thickening consistent with a prior diagnosis of osteopetrosis. MRI brain and orbits (Fig 2) confirmed an infiltrative process of the sella, cavernous sinuses, and orbits. Prolactin was mildly elevated (45.3 ng/ml) CBC, C-ANCA, and P-ANCA were normal. A diagnostic procedure was performed.
Disease/Diagnosis Erdheim Chester disease with BRAF V600E mutation positivity
Date 2020-03
References Blombery, Wong, Lade, Prince, Erdheim-Chester Disease Harboring the BRAF V600E Mutation, J Clin Oncol, 30, e331-e332, 2012. Diamond, Subbiah, Lockhart, Blay, Puzanov, Vemurafenib for BRAF V600-Mutant Erdheim-Chester Disease and Langerhans Cell Histiocytosis: Analysis of Data From the Histology-Independent, Phase 2, Open-label VE-BASKET Study, JAMA Oncol, 4, 384-388, 2018.
Language eng
Format video/mp4
Type Image/MovingImage
Source 2020 North American Neuro-Ophthalmology Society Annual Meeting
Relation is Part of NANOS Annual Meeting 2020: Frank B. Walsh Session 2
Collection Neuro-Ophthalmology Virtual Education Library - Walsh Session Annual Meeting Archives https://novel.utah.edu/Walsh/index3.html
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5985
Rights Management Copyright 2020. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6gn3gt3
Setname ehsl_novel_fbw
ID 1538212
Reference URL https://collections.lib.utah.edu/ark:/87278/s6gn3gt3
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