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Cerebral metastasis presenting with altitudinal field defect.

R S Newsom¹, P Simcock, H Zambarakji

¹Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society

|March 31, 1999

Summary

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A rare case of intracerebral melanoma metastasis caused a visual field defect in a 75-year-old man. This is the first reported instance of an intracranial tumor leading to this specific visual impairment.

Area of Science:

Ophthalmology
Neurology
Oncology

Background:

A 75-year-old male presented with symptoms suggestive of a serious underlying condition.
He reported a unilateral inferior altitudinal visual field defect, weight loss, and night sweats.

Observation:

Ocular examination revealed reduced visual acuity (20/200) in the affected eye, with other findings being normal.
Neuroimaging identified a post-fixed chiasm and a frontal metastasis compressing the optic nerve.
Chest X-ray revealed characteristic "cannon ball" lesions, indicative of metastatic malignant melanoma.

Findings:

This case represents the first documented instance of an intracerebral tumor causing an inferior altitudinal visual field defect.
The findings highlight the diverse neurological manifestations of metastatic melanoma.

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Implications:

This case underscores the importance of comprehensive diagnostic workups for visual field defects, considering potential intracranial pathologies.
It emphasizes the need for prompt identification and management of metastatic cancers presenting with atypical neurological symptoms.
Further research into the mechanisms of optic nerve compression by intracerebral tumors is warranted.