| Identifier |
walsh_2015_s4_c1-2 |
| Title |
Star Spangled Banner |
| Creator |
Dara M. Bier |
| Subject |
Neuroblastoma; Optic Nerve Glioma |
| History |
A 12-year-old girl with a history of bilateral optic nerve enlargement, enterovirus meningitis, seizures,and bilateral hygromas, presented with acute onset chronic vision loss in her left eye. Two years prior,she presented to an outside hospital with headaches, intermittent speech arrest and right-sided weakness,and was diagnosed with enterovirus meningitis and seizures. Incidentally, she was noted to havebilateral optic nerve enlargement. She had no visual symptoms until four months prior to presentationwhen she was again admitted with headaches and transient neurologic deficits. Neuroimaging wasnotable for new bilateral hygromas, further enlargement of the optic nerves, and septations of thesubarachnoid space thought to be related to prior meningitis. Lumbar puncture was unremarkable, andPET scan revealed a paraspinal mass near the left L4-L5 nerve root. Biopsy was consistent withneuroblastic tumor, thought to be isolated, and managed with partial resection. Additionally, extensivedural ectasia of the spine was observed. An attempt to drain the hygromas revealed high CSF output thatrequired subgaleal-peritoneal shunt placement, later removed due to infection. During her admission,she reported blurred vision. Initial ophthalmological evaluation revealed subnormal acuities in the leftmore than right eye and dyschromatopsia in both eyes, with normal pupils and optic discs. The etiologyof vision loss was postulated to be optic neuropathy secondary to high intracranial pressure from herhygromas. After discharge she remained stable for another three months until she noted complete visionloss in her left eye and was referred to our facility for neuro-ophthalmological consultation. Herexamination was significant for visual acuity of 20/60 in the right eye and light perception in the lefteye, a left afferent pupillary defect, and bilateral optic disc temporal pallor with nasal edema in the righteye. There were no Lisch nodules. |
| Disease/Diagnosis |
Neuroblastoma metastatic to pre-existing benign neoplasm of the optic nerves |
| Date |
2015-02 |
| References |
1. Belgaumi AF, Kauffman WM, Jenkins JJ, Cordoba J, Bowman LC, et al., Blindness in Children with Neuroblastoma, Cancer, 80(10):1997-2004, 1997. 2. Varma D, George N, Livingston J, Negi A, Willshaw HE, Acute visual loss as an early manifestation of metastatic neuroblastoma, Eye, 17: 250-252, 2003. 3. Lau JJC, Trobe JD, Ruiz RE, Cho RW, Wechsler DS, et al., Metastatic Neuroblastoma Presenting with Binocular Blindness from Intracranial Compression of the Optic Nerves, Journal of Neuro-Ophthalmology, 24(2): 119-124, 2004. 4. Balaji R, Ramachandran K, Kusumakumari P, Neuroimaging Patterns of Central Nervous System Metastases in Neuroblastoma: Report of 2 Recent Cases and Literature Review, Journal of Child Neurology, 24 (10): 1290-1293, 2009. 5. Gallet BL, Engelhoff JC, Unusual CNS and orbital metastases of neuroblastoma, Pediatric Radiology, 19:287-289, 1989. |
| Language |
eng |
| Format |
application/pdf |
| 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/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 84112-6221 |
| Rights Management |
Copyright 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6bk48xd |
| Setname |
ehsl_novel_fbw |
| ID |
179311 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6bk48xd |
