| Identifier |
walsh_2019_s3_c5 |
| Title |
Just the Two of Us |
| Creator |
Dan Milea, MD, PhD |
| Subject |
Tumor; Optic Neuropathy; Metastatic Carcinoma; Optic Nerve; Compressive Optic Neuropathy |
| History |
A 63-year-old female patient of Chinese ethnicity was referred for unexplained visual loss in her right eye, discovered incidentally 1 month before presentation. Her past medical history revealed quiescent asthma and a benign cyst in the left lung, excised 27 years earlier. The patient had no vascular risk factors and was not smoking. On examination, best-corrected vision was counting fingers in the right eye and 6/7.5 in the left eye, associated with severe color vision loss in the right eye. There was a dense right relative afferent pupillary defect, but the remainder of the neuro-ophthalmic examination was normal, including fundoscopy, ocular motility and other cranial nerves functions. There was a dense visual field defect in the right eye and a Cirrus OCT disclosed normal retinal nerve fiber layer thickness in both eyes. The presumptive diagnosis was unexplained right retrobulbar optic neuropathy. A brain MRI disclosed an enhancing mass involving the anterior right clivus and apex, infiltrating the ipsilateral cavernous sinus, highly suggestive of meningioma. Excision of the tumor was decided by the neuro-surgical team, and pathology confirmed a WHO Grade III parapapillary chordoid meningioma. Post- operatively, the patient had an ispilateral iatrogenic pupil-involving 3rd nerve palsy, an ipsilateral 4th nerve palsy and developed a right soleal vein thrombosis, treated symptomatically. However, the patient's main post-operative complaint was persistent coughing. |
| Disease/Diagnosis |
Intra-meningioma tumor-to-tumor metastasis of previously undiagnosed lung adenocarcinoma. |
| Date |
2019-03 |
| References |
1/ Sohail S, Karambizi DI, Baker A, Groh DM, Toms SA. A Comparative Report on Intracranial Tumor-to-Tumor Metastasis and Collision Tumors. World Neurosurgery 2018;116:454-463 2/ Caroli E, Salvati M, Giangaspero F, Ferrante L, Santoro A. Intrameningioma metastasis as first clinical manifestation of occult primary breast carcinoma. Neurosurg Rev 2006;29:49-54. |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/Moving |
| Source |
2019 North American Neuro-Ophthalmology Society Annual Meeting |
| Relation is Part of |
NANOS Annual Meeting 2019: Frank B. Walsh Session 3 |
| 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 84112-6032 |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6bw20sn |
| Setname |
ehsl_novel_fbw |
| ID |
1431973 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6bw20sn |
