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Metastatic paraganglioma presenting as ajunctional scotoma
Mohamed M Khodeiry1,2, John T Lind3, Joshua Pasol1
1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
American Journal of Ophthalmology Case Reports
|January 17, 2022
Summary
Metastatic paraganglioma, a rare cancer, can cause a junctional scotoma, a specific visual field defect. This case highlights the importance of neuro-ophthalmic evaluation for vision changes, even with good visual acuity.
Area of Science:
- Neuro-oncology
- Ophthalmology
- Endocrinology
Background:
- Paragangliomas are rare neuroendocrine tumors that can metastasize.
- Metastatic disease can present with varied and sometimes subtle neurological symptoms.
Observation:
- A 38-year-old man with known abdominal paraganglioma developed blurred vision.
- Visual field testing revealed a junctional scotoma in the left eye.
- Cranial MRI identified a peri-clival mass compressing optic nerves and other metastatic lesions.
Findings:
- This is the first reported case of metastatic paraganglioma presenting as a junctional scotoma.
- The patient had relatively preserved visual acuity despite significant intracranial metastatic disease.
Implications:
- Junctional scotoma warrants thorough neuro-ophthalmic assessment and imaging.
- Even with good visual acuity, unexplained visual symptoms in patients with paraganglioma require investigation.
- This case expands the spectrum of clinical presentations for metastatic paraganglioma.
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