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Optic nerve metastasis simulating optic neuritis

J Pengel1, L Crevits, P Wynants

  • 1Department of Neurology, University Hospital of Ghent, Belgium.

Clinical Neurology and Neurosurgery
|February 1, 1997
PubMed
Summary
This summary is machine-generated.

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A 68-year-old man experienced rapid vision loss due to metastatic cancer invading his optic nerves. Despite treatment, the condition was fatal, highlighting a rare presentation of occult malignancy.

Area of Science:

  • Neurology
  • Oncology
  • Ophthalmology

Background:

  • Metastatic tumors rarely present with isolated optic nerve involvement.
  • Optic neuropathy can be a challenging diagnosis, especially with atypical presentations.

Observation:

  • A 68-year-old male presented with subacute bilateral vision loss.
  • Neurological examination was otherwise unremarkable.
  • MRI revealed scattered periventricular white matter T2 hyperintensities.
  • Cerebrospinal fluid analysis showed mononuclear pleocytosis and oligoclonal gamma bands.

Findings:

  • Intravenous corticosteroid treatment was ineffective.
  • The patient's condition worsened, leading to death from bronchopneumonia.
  • Postmortem examination confirmed metastatic invasion of both optic nerves from an undetectable primary tumor.

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Implications:

  • This case underscores the importance of considering occult malignancies in unexplained optic neuropathies.
  • Atypical presentations of cancer metastasis can mimic inflammatory or demyelinating diseases.
  • Early detection and diagnosis of such cases remain critical for patient outcomes.