Acute monocular visual loss in carcinomatous hypertrophic pachymeningitis mimicking giant cell arteritis.
This report describes a 69-year-old woman who presented with acute monocular visual loss, ipsilateral headache, and elevated sedimentation rate and C-reactive protein. Both temporal artery biopsies were negative. Neuroimaging, dural biopsy, and breast biopsy all confirmed the diagnosis of carcinomatous hypertrophic pachymeningitis associated with metastatic breast carcinoma. After treatment with corticosteroids, her vision improved. Her clinical presentation initially mimicked the symptoms and signs of giant cell arteritis. Acute monocular visual loss without other cranial nerve palsies may be an uncommon presentation of hypertrophic pachymeningitis from metastatic breast carcinoma.
Department of Neurology, University of Nevada School of Medicine, Las Vegas, Nevada 89102, USA. worjun@aol.com
Jane W
JW
Chan
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D001706:Biopsy; D001799:Blood Sedimentation; D001943:Breast Neoplasms / Q000473:pathology*; D002097:C-Reactive Protein / Q000378:metabolism; D003389:Cranial Nerve Diseases / Q000175:diagnosis* / Q000209:etiology*; D003937:Diagnosis, Differential; D004388:Dura Mater / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis; D006261:Headache / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D006984:Hypertrophy; D008279:Magnetic Resonance Imaging; D008581:Meningitis / Q000209:etiology* / Q000473:pathology*; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology*
D000305:Adrenal Cortex Hormones; D002097:C-Reactive Protein