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Neoplastic leptomeningeal disease masquerading as central serous retinopathy. A case report

A 69-year-old man became aware of people’s speech being out of synch with their lip movements alongside persistent headaches, both of which progressively worsened. A few weeks later, he developed progressive and painless visual loss in one eye. Initial neurological evaluation, inflammatory markers a...

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Detalles Bibliográficos
Autores principales: Elaraoud, Ibrahim, Suleman, Hanif J., Cikatricis, Peter, Palmer, Helen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5299102/
https://www.ncbi.nlm.nih.gov/pubmed/28210185
http://dx.doi.org/10.1016/j.sjopt.2016.07.003
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author Elaraoud, Ibrahim
Suleman, Hanif J.
Cikatricis, Peter
Palmer, Helen
author_facet Elaraoud, Ibrahim
Suleman, Hanif J.
Cikatricis, Peter
Palmer, Helen
author_sort Elaraoud, Ibrahim
collection PubMed
description A 69-year-old man became aware of people’s speech being out of synch with their lip movements alongside persistent headaches, both of which progressively worsened. A few weeks later, he developed progressive and painless visual loss in one eye. Initial neurological evaluation, inflammatory markers and head computed tomography scan were normal. Ophthalmological examination and OCT scan revealed right macular subretinal fluid with choroidal indentation, which prompted urgent further investigations including head MRI revealing extensive leptomeningeal disease. The patient continued to deteriorate and deceased shortly afterwards. This is the first reported case of neoplastic leptomeningeal disease presenting with loss of vision due to choroidal metastasis with localised exudative retinal detachment. Diagnosing neoplastic leptomeningeal disease requires a high index of suspicion from the treating physician. Symptoms may be nonspecific and/or subtle. Combining cerebrospinal fluid cytology from lumbar puncture with contrast-enhanced magnetic resonance imaging of the brain is considered the optimal diagnostic approach.
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spelling pubmed-52991022017-02-16 Neoplastic leptomeningeal disease masquerading as central serous retinopathy. A case report Elaraoud, Ibrahim Suleman, Hanif J. Cikatricis, Peter Palmer, Helen Saudi J Ophthalmol Case Report A 69-year-old man became aware of people’s speech being out of synch with their lip movements alongside persistent headaches, both of which progressively worsened. A few weeks later, he developed progressive and painless visual loss in one eye. Initial neurological evaluation, inflammatory markers and head computed tomography scan were normal. Ophthalmological examination and OCT scan revealed right macular subretinal fluid with choroidal indentation, which prompted urgent further investigations including head MRI revealing extensive leptomeningeal disease. The patient continued to deteriorate and deceased shortly afterwards. This is the first reported case of neoplastic leptomeningeal disease presenting with loss of vision due to choroidal metastasis with localised exudative retinal detachment. Diagnosing neoplastic leptomeningeal disease requires a high index of suspicion from the treating physician. Symptoms may be nonspecific and/or subtle. Combining cerebrospinal fluid cytology from lumbar puncture with contrast-enhanced magnetic resonance imaging of the brain is considered the optimal diagnostic approach. Elsevier 2016 2016-07-18 /pmc/articles/PMC5299102/ /pubmed/28210185 http://dx.doi.org/10.1016/j.sjopt.2016.07.003 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Elaraoud, Ibrahim
Suleman, Hanif J.
Cikatricis, Peter
Palmer, Helen
Neoplastic leptomeningeal disease masquerading as central serous retinopathy. A case report
title Neoplastic leptomeningeal disease masquerading as central serous retinopathy. A case report
title_full Neoplastic leptomeningeal disease masquerading as central serous retinopathy. A case report
title_fullStr Neoplastic leptomeningeal disease masquerading as central serous retinopathy. A case report
title_full_unstemmed Neoplastic leptomeningeal disease masquerading as central serous retinopathy. A case report
title_short Neoplastic leptomeningeal disease masquerading as central serous retinopathy. A case report
title_sort neoplastic leptomeningeal disease masquerading as central serous retinopathy. a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5299102/
https://www.ncbi.nlm.nih.gov/pubmed/28210185
http://dx.doi.org/10.1016/j.sjopt.2016.07.003
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