RAPID ONSET OF BLINDNESS DUE TO MENINGEAL CARCINOMATOSIS FROM AN ESOPHAGEAL ADENOCARCINOMA
RAPID ONSET OF BLINDNESS DUE TO MENINGEAL CARCINOMATOSIS FROM AN ESOPHAGEAL ADENOCARCINOMA
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DOI：
10.1136/pgmj.67.792.909
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发表时间：
1991-10-01
影响因子：
5.1
通讯作者：
COKER, RJ
中科院分区：
文献类型：
--
作者：
TEARE, JP;WHITEHEAD, M;COKER, RJ
我们报告一位49岁的男性，以左腿无力、前额头痛、注意力不集中及吞咽困难来就诊。 在吞钡和食管镜检查中，认为他有良性食管狭窄，尽管最初没有进行活检。 在住院期间，他的视力恶化，以至于他只能识别明亮的光线。 重复食管镜检查证实为食管腺癌。 脑膜癌病的诊断是在死后证实的。突然的双侧失明是脑膜癌病的常见特征，但由于这是罕见的，它通常不被认为是在视力丧失的鉴别诊断。 视力丧失可以解释为血管功能不全与视神经鞘的蛛网膜下腔的肿瘤袖套、神经元毒素或其他未知机制相关。
We report a 49 year old man who presented with left leg weakness, frontal headache, impaired concentration and dysphagia. He was thought to have a benign oesophageal stricture on barium swallow and oesophagoscopy though this was not initially biopsied. During admission his vision deteriorated so that he could only recognize bright light. Repeat oesophagoscopy demonstrated an oesophageal adenocarcinoma. The diagnosis of meningeal carcinomatosis was confirmed at post-mortem.Sudden bilateral blindness is a common feature of meningeal carcinomatosis but, as this is rare, it is not commonly considered in the differential diagnosis of visual loss. The visual loss can be explained by vascular insufficiency in association with tumour cuffing of the subarachnoid space of the optic nerve sheath, by neuronal toxins, or other, as yet unknown, mechanisms.