Falx Meningeoma Induced Optic Neuropathy—Clinical Manifestation and Differential Diagnosis: A Case Report

Abstract

Purpose: Meningiomas are the most frequently diagnosed neoplasms. Ocular symptoms vary depending on size and localisation of the tumor, which is capable of compressing critical anatomic structures. Patients and Methods: A 44-year-old immunocompetent male was admitted to our hospital for further investigation of his bilateral optic disc swelling. A complete ophthalmological examination was performed including visual field assessment (VF), visual evoked potentials (VEP), fluorescein angiography (FLA) and magnetic resonance imaging (MRI). The patient had experienced only minor visual disturbances. Serological testing was performed. Results: Serological testing showed positive IgM and IgGtiters for cytomegalovirus (CMV) and subsequent imaging (MRI) revealed a frontal falxcerebri meningioma. Conclusions: We present a case of falx meningioma with overlapping serologically active CMV in an otherwise healthy and immunocompetent individual. Detailed differential diagnostic workup in immunocompetent individuals presenting with clinically unremarkable bilateral disc swelling is recommended.

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Christos, S. , Carolin, G. , Gisbert, R. and Stephan, L. (2013) Falx Meningeoma Induced Optic Neuropathy—Clinical Manifestation and Differential Diagnosis: A Case Report. Open Journal of Ophthalmology, 3, 87-89. doi: 10.4236/ojoph.2013.33020.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] CBTRUS, “Statistical Report: Primary Brain and Central Nervous System Tumors Diagnosed in Eighteen States in 2002-2006,” Central Brain Tumor Registry of the United States, Hinsdale, 2009-2010.
[2] H. Cushing and L. Eisenhardt, “Meningiomas. Their Classification, Regional Behavior, Life History and Surgical End Results,” Bulletin of the Medical Library Association, Vol. 27, No. 2, 1938, pp. 224-249.
[3] D. I. Friedman and D. M. Jacobson, “Diagnostic Criteria for Idiopathic Intracranial Hypertension,” Neurology, Vol. 59, No. 10, 2002, pp. 1492-1495.
[4] S. S. Hayreh, “Optic Disc Edema in Raised Intracranial Pressure. VI. Associated Visual Disturbances and Their Pathogenesis,” Archives of Ophthalmology, Vol. 95, No. 9, 1977, pp. 1566-1579. doi:10.1001/archopht.1977.04450090088007
[5] H. E. Grossniklaus, K. E. Frank and R. L. Tomsak, “Cytomegalovirus Retinitis and Optic Neuritis in Acquired Immune Deficiency Syndrome: Report of a Case,” Ophthalmology, Vol. 94, No. 12, 1987, pp. 1601-1604.
[6] J. D. Roarty, E. J. Fisher and J. J. Nussbaum, “Long-Term Visual Morbidity of Cytomegalovirus Retinitis in Patients with Acquired Immune Deficiency Syndrome,” Ophthalmology, Vol. 100, No. 11, 1993, pp. 1685-1688.
[7] D. N. Friedberg, “Cytomegalovirus Retinitis: Diagnosis and Status of Systemic Therapy,” Journal of Acquired Immune Deficiency Syndromes & Human Retrovirology, Vol. 14, No. 1, 1997, pp. S1-S6. doi:10.1097/00042560-199700001-00002
[8] A. M. Mansor and H. K. Li, “Cytomegalovirus Optic Neuritis: Characteristics, Therapy and Survival,” Ophthalmologica, Vol. 209, No. 5, 1995, pp. 260-266. doi:10.1159/000310627
[9] E. Baglivo, P. M. Leuenberger and K. H. Krause, “Presumed Bilateral Cytomegalovirus-Induced Optic Neuropathy in an Immunocompetent Person: A Case Report,” Journal of Neuro-Ophthalmology, Vol. 16, No. 1, 1996, pp. 14-17. doi:10.1097/00041327-199603000-00004
[10] S. R. De Silva, G. Chohan, D. Jones and M. Hu, “Cytomegalovirus Papillitis in an Immunocompetent Patient,” Journal of Neuro-Ophthalmology, Vol. 28, No. 2, 2008, pp. 126-127. doi:10.1097/WNO.0b013e3181782fed

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