Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic Meningitis
Introduction. Leptomeningeal carcinomatosis occurs in about 5% of cancer patients. Ocular involvement is a common clinical manifestation and often the presenting clinical feature. Materials and Methods. We report the case of a 52-year old lady with optic neuritis as isolated manifestation of neoplas...
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Wiley
2013-01-01
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| Series: | Neurology Research International |
| Online Access: | http://dx.doi.org/10.1155/2013/892523 |
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| author | Silvia Lanfranconi Paola Basilico Ilaria Trezzi Linda Borellini Giulia Franco Vittorio Civelli Francesco Pallotti Nereo Bresolin Pierluigi Baron |
| author_facet | Silvia Lanfranconi Paola Basilico Ilaria Trezzi Linda Borellini Giulia Franco Vittorio Civelli Francesco Pallotti Nereo Bresolin Pierluigi Baron |
| author_sort | Silvia Lanfranconi |
| collection | DOAJ |
| description | Introduction. Leptomeningeal carcinomatosis occurs in about 5% of cancer patients. Ocular involvement is a common clinical manifestation and often the presenting clinical feature. Materials and Methods. We report the case of a 52-year old lady with optic neuritis as isolated manifestation of neoplastic meningitis and a review of ocular involvement in neoplastic meningitis. Ocular symptoms were the presenting clinical feature in 34 patients (83%) out of 41 included in our review, the unique manifestation of meningeal carcinomatosis in 3 patients (7%). Visual loss was the presenting clinical manifestation in 17 patients (50%) and was the most common ocular symptom (70%). Other ocular signs were diplopia, ptosis, papilledema, anisocoria, exophthalmos, orbital pain, scotomas, hemianopsia, and nystagmus. Associated clinical symptoms were headache, altered consciousness, meningism, limb weakness, ataxia, dizziness, seizures, and other cranial nerves involvement. All patients except five underwent CSF examination which was normal in 1 patient, pleocytosis was found in 11 patients, increased protein levels were observed in 16 patients, and decreased glucose levels were found in 8 patients. Cytology was positive in 29 patients (76%). Conclusion. Meningeal carcinomatosis should be considered in patients with ocular symptoms even in the absence of other suggestive clinical symptoms. |
| format | Article |
| id | doaj-art-acd29f607cf0478d911af374e7742e19 |
| institution | OA Journals |
| issn | 2090-1852 2090-1860 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Neurology Research International |
| spelling | doaj-art-acd29f607cf0478d911af374e7742e192025-08-20T02:20:23ZengWileyNeurology Research International2090-18522090-18602013-01-01201310.1155/2013/892523892523Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic MeningitisSilvia Lanfranconi0Paola Basilico1Ilaria Trezzi2Linda Borellini3Giulia Franco4Vittorio Civelli5Francesco Pallotti6Nereo Bresolin7Pierluigi Baron8Department of Neurological Sciences, Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, 20122 Milan, ItalyDepartment of Neurological Sciences, Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, 20122 Milan, ItalyDepartment of Neurological Sciences, Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, 20122 Milan, ItalyDepartment of Neurological Sciences, Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, 20122 Milan, ItalyDepartment of Neurological Sciences, Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, 20122 Milan, ItalyDepartment of Neuroradiology and Interventional Neuroradiology, Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Pathological Anatomy, Fondazione Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Neurological Sciences, Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, 20122 Milan, ItalyDepartment of Neurological Sciences, Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, 20122 Milan, ItalyIntroduction. Leptomeningeal carcinomatosis occurs in about 5% of cancer patients. Ocular involvement is a common clinical manifestation and often the presenting clinical feature. Materials and Methods. We report the case of a 52-year old lady with optic neuritis as isolated manifestation of neoplastic meningitis and a review of ocular involvement in neoplastic meningitis. Ocular symptoms were the presenting clinical feature in 34 patients (83%) out of 41 included in our review, the unique manifestation of meningeal carcinomatosis in 3 patients (7%). Visual loss was the presenting clinical manifestation in 17 patients (50%) and was the most common ocular symptom (70%). Other ocular signs were diplopia, ptosis, papilledema, anisocoria, exophthalmos, orbital pain, scotomas, hemianopsia, and nystagmus. Associated clinical symptoms were headache, altered consciousness, meningism, limb weakness, ataxia, dizziness, seizures, and other cranial nerves involvement. All patients except five underwent CSF examination which was normal in 1 patient, pleocytosis was found in 11 patients, increased protein levels were observed in 16 patients, and decreased glucose levels were found in 8 patients. Cytology was positive in 29 patients (76%). Conclusion. Meningeal carcinomatosis should be considered in patients with ocular symptoms even in the absence of other suggestive clinical symptoms.http://dx.doi.org/10.1155/2013/892523 |
| spellingShingle | Silvia Lanfranconi Paola Basilico Ilaria Trezzi Linda Borellini Giulia Franco Vittorio Civelli Francesco Pallotti Nereo Bresolin Pierluigi Baron Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic Meningitis Neurology Research International |
| title | Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic Meningitis |
| title_full | Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic Meningitis |
| title_fullStr | Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic Meningitis |
| title_full_unstemmed | Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic Meningitis |
| title_short | Optic Neuritis as Isolated Manifestation of Leptomeningeal Carcinomatosis: A Case Report and Systematic Review of Ocular Manifestations of Neoplastic Meningitis |
| title_sort | optic neuritis as isolated manifestation of leptomeningeal carcinomatosis a case report and systematic review of ocular manifestations of neoplastic meningitis |
| url | http://dx.doi.org/10.1155/2013/892523 |
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