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Olfactory Neuroblastoma: An Unusual Ocular Presentation
Dhabiah Saeed AlQahtani1, Abdulaziz A Alshamrani1, Raniah AlQawahmed2
1Ophthalmology Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
Neuro-Ophthalmology (Aeolus Press)
|May 16, 2022
Summary
A rare olfactory neuroblastoma (ONB) case presented with severe vision loss due to papilledema from increased intracranial pressure. This highlights ONB
Area of Science:
- Neuro-oncology
- Ophthalmology
Background:
- Olfactory neuroblastoma (ONB) is a rare malignant tumor originating from the olfactory epithelium.
- ONBs typically present with sinonasal symptoms, and rarely involve ocular manifestations.
Observation:
- A 51-year-old male presented with gradual, painless vision loss in both eyes over three months.
- Ophthalmological examination revealed severe bilateral papilledema and engorged retinal veins, with significantly reduced visual acuity.
- Neurological and ophthalmological examinations were otherwise normal, with no signs of ophthalmoplegia, proptosis, or sinonasal symptoms.
Findings:
- Intracranial imaging identified a large tumor causing elevated intracranial pressure.
- Neurosurgical debulking and subsequent histological analysis confirmed the tumor as an olfactory neuroblastoma (ONB).
- This case is unique as the ONB manifested solely with papilledema, without other typical presenting symptoms.
Implications:
- This case underscores the importance of considering rare intracranial tumors in the differential diagnosis of unexplained papilledema and vision loss.
- It highlights that olfactory neuroblastomas can present atypically, emphasizing the need for comprehensive diagnostic workups.
- Early detection and management of such atypical presentations are crucial for improving patient outcomes.
