title: A case of monocular blindness as the initial presentation of hepatocellular carcinoma with skull metastasis.
abstract: A 52-year-old man suffering from monocular blindness, with light perception only, was admitted to our hospital. The symptom had begun as low vision and developed rapidly within 3 weeks into monocular blindness in the right eye, with no other systemic manifestations. Imaging examinations revealed multiple hepatocellular carcinomas in the cirrhotic liver, and tumors at the skull base and vertebra. A pathological and immunochemical study of specimens obtained by endoscopic transnasal tumor biopsy and laminectomy revealed them to be metastatic hepatocellular carcinomas (HCCs). Although the patient underwent radiation therapy and chemotherapy, he died 5 months after admission to our hospital. The cranial HCC, involving only the optic canal, may have disturbed the optic nerve in preference to the other cranial nerves. This is the first report of a HCC patient with monocular blindness as the initial presentation of the disease.
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan. jxi9@med.id.yamagata-u.ac.jp.
authors.forename: Junitsu
authors.initials: J
authors.lastname: Ito
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Saito
authors.affiliation: Department of Diagnostic Pathology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Iwaba
authors.affiliation: Department of Gastroenterology, Nihonkai General Hospital, 30 Akiho-cho, Sakata, Yamagata, 998-8501, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Sanjo
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Ishii
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Chikako
authors.initials: C
authors.lastname: Sato
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Haga
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Okumoto
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nishise
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Saito
authors.affiliation: Health Administrative Center, Yamagata University, 1-4-12 Kojirakawa, Yamagata, 990-9560, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Togashi
authors.affiliation: Department of Gastroenterology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
authors.forename: Sumio
authors.initials: S
authors.lastname: Kawata
keywords: Blindness; Hepatocellular carcinoma; Metastasis