ABSTRACT
OBJECTIVE: Pituitary carcinoma is a rare tumor, defined as a tumor of adenohypophyseal cells with systemic or craniospinal metastasis. We present a case of a growth hormone (GH)-secreting pituitary carcinoma with a review of literature to better characterize this disease. DESIGN: Case report and literature review of 25 cases of GH-secreting pituitary carcinomas RESULTS: The age of diagnosis of GH-secreting carcinomas ranged 24-69 years old with a mean age of 44.4 with 52% of cases present in females. Mean latency period between diagnosis of acromegaly and transition to pituitary carcinoma was 11.4 years with mean survival being 3.4 years. CONCLUSION: Growth hormone (GH)-secreting pituitary carcinomas are rare and hard to distinguish from aggressive pituitary adenomas. From review of literature, treatment options include debulking surgery, radiotherapy, or chemotherapy with dismal outcomes. There are no diagnostic markers or features which can predict metastatic progression of these tumors. Future studies with genomic landscapes and relevant tumor markers are needed to identify pituitary tumors most likely to metastasize.
Subject(s)
Acromegaly/complications , Adenoma/pathology , Human Growth Hormone/metabolism , Insulin-Like Growth Factor I/metabolism , Pituitary Neoplasms/pathology , Adenoma/etiology , Adenoma/metabolism , Female , Humans , Middle Aged , Pituitary Neoplasms/etiology , Pituitary Neoplasms/metabolism , PrognosisABSTRACT
A 73-year-old woman presented with 3 years of monocular visual distortion and progressive binocular diplopia. She was found to have a comitant left hypertropia due to an epiretinal membrane causing inferior foveal drag. Displacement of the fovea from an epiretinal membrane is a likely under-recognized cause ocular cause of a comitant binocular diplopia.
Subject(s)
Diplopia/etiology , Epiretinal Membrane/complications , Visual Acuity/physiology , Aged , Diplopia/physiopathology , Epiretinal Membrane/physiopathology , Female , Humans , Macula Lutea/physiopathologyABSTRACT
While cerebral amyloid angiopathy is a common cause of lobar hemorrhage, rarely it may be associated with an inflammatory response, thought to be incited by amyloid deposits. We report a 73-year-old woman with an extensive cancer history who presented with tumor-like lesions and symptoms of homonymous hemianopia and prosopagnosia. Found to have cerebral amyloid angiopathy-related inflammation proven by brain biopsy, she was treated successfully with immunosuppression.
Subject(s)
Adenocarcinoma/complications , Cerebral Amyloid Angiopathy/complications , Hemianopsia/etiology , Lung Neoplasms/complications , Prosopagnosia/etiology , Adenocarcinoma/diagnosis , Adenocarcinoma of Lung , Aged , Biopsy , Cerebral Amyloid Angiopathy/diagnosis , Female , Hemianopsia/diagnosis , Humans , Lung Neoplasms/diagnosis , Magnetic Resonance Imaging , Positron-Emission Tomography , Prosopagnosia/diagnosis , Tomography, X-Ray ComputedSubject(s)
Optic Neuritis/diagnosis , Optic Neuritis/physiopathology , Adolescent , Adult , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
Olfactory groove meningiomas can present as large and insidious masses in the anterior cranial base. Due to their location and minimal clinical symptoms, these tumors can go undetected until they have grown extremely large. We present a clinical case and discuss the surgical management of a 63-year-old man who presented for an initial eye examination with bilateral visual loss for over 2 years due to a giant olfactory meningioma encompassing his entire frontal lobe and compressing on his optic nerves.
ABSTRACT
A 45-year-old patient presented with bilateral orbital abscesses. He was found to have Lemierre syndrome, a condition involving septic thrombophlebitis of the internal jugular vein. The patient developed severe proptosis, sepsis, and cavernous sinus thrombosis. Despite aggressive antibiotic and anticoagulation therapy, visual loss was rapid, and the patient ultimately died. Lemierre syndrome, previously thought to be rare, is now becoming more commonly reported. Its prompt diagnosis and treatment are essential for patient survival.
Subject(s)
Abscess/microbiology , Bacteremia/microbiology , Lemierre Syndrome/microbiology , Orbital Diseases/microbiology , Streptococcal Infections/microbiology , Streptococcus milleri Group/isolation & purification , Abscess/diagnosis , Abscess/therapy , Bacteremia/diagnosis , Bacteremia/therapy , Cavernous Sinus Thrombosis/diagnosis , Cavernous Sinus Thrombosis/microbiology , Fatal Outcome , Humans , Lemierre Syndrome/diagnosis , Lemierre Syndrome/therapy , Male , Middle Aged , Orbital Cellulitis/diagnosis , Orbital Cellulitis/microbiology , Orbital Diseases/diagnosis , Orbital Diseases/therapy , Streptococcal Infections/diagnosis , Streptococcal Infections/therapy , Tomography, X-Ray ComputedABSTRACT
A 72-year-old previously healthy man developed rapidly progressive visual loss, and brain imaging showed features suggestive of a malignant glioma of the anterior visual pathway. Biopsy of one optic nerve yielded a diagnosis of lymphoma. There was no evidence of an extracranial non-Hodgkin lymphoma, so the conclusion was that this represented a primary central nervous system lymphoma (PCNSL). PCNSL isolated to the optic chiasm has been described only once in an immunocompetent patient. Our patient is unusual in that the lymphoma involved the optic nerve, chiasm, and tract in an immunocompetent patient.
Subject(s)
Lymphoma, B-Cell/diagnosis , Optic Chiasm/pathology , Optic Nerve Neoplasms/diagnosis , Optic Nerve/pathology , Vision, Low/etiology , Vision, Low/pathology , Aged , Antigens, Neoplasm/analysis , Antigens, Neoplasm/immunology , Antimetabolites, Antineoplastic/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , Biomarkers, Tumor/analysis , Biomarkers, Tumor/immunology , Biopsy , Diagnosis, Differential , Disease Progression , Fatal Outcome , Humans , Leucovorin/therapeutic use , Lymphoma, B-Cell/physiopathology , Magnetic Resonance Imaging , Male , Methotrexate/therapeutic use , Neoplasm Invasiveness/pathology , Optic Chiasm/physiopathology , Optic Nerve/physiopathology , Optic Nerve Neoplasms/physiopathology , Prednisone/therapeutic use , Treatment Failure , Vision, Low/physiopathology , Vitamin B Complex/therapeutic useSubject(s)
Intracranial Arteriovenous Malformations/complications , Orbit/blood supply , Retinal Vein Occlusion/complications , Venous Thrombosis/complications , Coloring Agents , Fluorescein Angiography , Humans , Indocyanine Green , Intracranial Arteriovenous Malformations/diagnosis , Male , Middle Aged , Retinal Vein Occlusion/diagnosis , Veins , Venous Thrombosis/diagnosisABSTRACT
PURPOSE: To report optical coherence tomography findings in nicotinic acid maculopathy. DESIGN: Observational case report. METHOD: The patient was examined with ophthalmoscopy, fluorescein angiography, and optical coherence tomography. RESULTS: A 71-year-old man presented with bilateral decreased visual acuity with metamorphopsia. Optical coherence tomography demonstrated cystoid spaces in the outer plexiform layer and inner nuclear layer. Fluorescein angiography did not show leakage. Two weeks after stopping the nicotinic acid, the cystoid spaces resolved. CONCLUSIONS: Niacin maculopathy causes cystoid spaces in the inner nuclear and outer plexiform layers that resolve with discontinuation of the drug.
Subject(s)
Hypolipidemic Agents/adverse effects , Niacin/adverse effects , Retina/drug effects , Retinal Diseases/chemically induced , Aged , Fluorescein Angiography , Humans , Hypercholesterolemia/drug therapy , Interferometry , Light , Male , Ophthalmoscopy , Retina/pathology , Retinal Diseases/diagnosis , Retinal Diseases/physiopathology , Tomography , Vision Disorders/chemically induced , Vision Disorders/diagnosis , Vision Disorders/physiopathology , Visual Acuity/drug effectsABSTRACT
BACKGROUND: Ocular manifestations of Wilms' tumor are rare, particularly in adults. We present the first reported case of a choroidal metastasis resulting from Wilms' tumor. DESIGN: Case report. PARTICIPANT: A 37-year-old white male with an adult-onset biopsy-proven Wilms' tumor with multiorgan metastatic disease. RESULTS: We report a unique case of uveal metastasis presumed from a Wilms' tumor. The patient's history included a primary Wilms' tumor with known disseminated metastasis, orbital pain, metamorphopsia, and decreased vision. Ophthalmoscopy revealed a unifocal choroidal tumor in the inferotemporal quadrant of the right eye. Ultrasonographic measurements of the tumor were 4.9 mm in apical height and 15 x 13 mm in basal diameter. Unusual ultrasound findings included echodense stromal opacities and retrobulbar edema. Fluorescein angiography revealed double circulation and late intratumoral fluorescence. CONCLUSIONS: This is the first reported case of a choroidal metastasis by a Wilms' tumor.
