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Medulloblastoma causing a corticosteroid-responsive optic neuropathy

L W Hirst, N R Miller, A J Kumar

    American Journal of Ophthalmology
    |March 1, 1980
    PubMed
    Summary
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    A young man

    Area of Science:

    • Neuro-oncology
    • Ophthalmology
    • Neurology

    Background:

    • Optic neuritis typically presents with optic nerve dysfunction.
    • Corticosteroids are a common treatment for optic neuritis.

    Observation:

    • A 25-year-old man presented with optic nerve dysfunction, initially diagnosed as optic neuritis and treated with corticosteroids.
    • Recurrent symptoms after corticosteroid tapering led to repeat imaging, revealing a posterior-fossa medulloblastoma compressing the optic nerve.
    • This case represents the first reported instance of direct optic nerve compression by medulloblastoma extension.

    Findings:

    • Medulloblastoma can directly compress the optic nerve, mimicking optic neuritis.
    • The tumor responded favorably to corticosteroids, initially suggesting an inflammatory process.

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  • Histological confirmation identified typical medulloblastoma.

    • Implications:

    • Optic neuritis with atypical or recurrent symptoms warrants thorough investigation for underlying mass lesions.
    • Direct optic nerve compression by medulloblastoma is a rare but significant presentation.
    • This case highlights the importance of reassessing optic neuritis diagnoses when clinical course is unusual.