Tuberculum sellae meningioma associated with lymphomatoid papulosis.
BACKGROUND
Meningiomas involving the tuberculum sellae and planum sphenoidale typically cause visual loss by affecting the optic nerve and anterior chiasm. We present a case of a tuberculum sellae meningioma concurrent with lymphomatoid papulosis, a T-cell lymphomatoid skin disorder.


METHODS
A 50-year-old black woman came to the eye clinic with a symptom of decreased vision in the right eye for one week, especially when reading. Best-corrected vision was counting fingers at two feet O.D. and 20/40 O.S. She was seen seven months earlier, with 20/25 O.D. and O.S. Dilated fundus examination revealed bilateral optic atrophy, O.D. greater than O.S. MRI revealed a meningioma arising from the tuberculum sellae and planum sphenoidale region. The meningioma was partially resected nine days later Visual field performed 18 days postoperatively demonstrated an overall depression in the right eye and no defect in the left eye. Best-corrected vision improved to 20/150 O.D. and 20/30 O.S.


CONCLUSIONS
Meningiomas are generally benign tumors that can cause symptoms if vital structures are compromised. Altered visual function and optic atrophy may be the only presentation of intracranial and orbital tumors. Intracranial meningiomas may be associated with systemic conditions that can infiltrate the optic nerve, including lymphocytic disorders. Lymphomatoid papulosis (LyP) is a rare cutaneous disorder involving infiltrating clonal T-cells that has been associated with disseminated lymphomatic skin tumors. It is unclear if there is a direct association between LyP and meningiomas.
Ong
Lee
L
VA Greater Los Angeles Healthcare System, Sepulveda Ambulatory Care Center and Nursing Home, Sepulveda, Calfornia, USA. drong@caloaksvision.com
Ferrucci
Steve
S
D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D017731:Lymphomatoid Papulosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008579:Meningioma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009896:Optic Atrophy / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012658:Sella Turcica / Q000473:pathology*; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014792:Visual Acuity; D014794:Visual Fields