Homonymous Quadrantanopsia as the First Manifestation of Cerebral Metastasis of Invasive Mole: a case report

Journal of Medical Case Reports

Meng-Hui Li¹  Yuan Li³  Feng Feng⁴  Yong Zhong⁵  De-Lu Song² 

[1] Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China;Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine. Philadelphia, PA, USA;Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China;Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China;Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1# Shuaifuyuan, Beijing 100730, China

关键词: Invasive mole;    Homonymous Quadrantanopsia;    Cerebral metastasis;   

Others  :  1195824
DOI  :  10.1186/1752-1947-6-117

 received in 2011-09-05, accepted in 2012-04-24,  发布年份 2012

【 摘 要 】

Introduction

Homonymous quadrantanopsia results from retrochiasmal lesions in the visual pathway. Invasive mole is a benign tumor that arises from myometrial invasion of a hydatidiform mole via direct extension through tissue or venous channels. Cerebral metastasis of invasive mole is rare and there has been no report demonstrating homonymous quadrantanopsia as the first manifestation of metastasis in any trophoblastic neoplasms.

Case presentation

We report the case of a 31-year-old Asian woman who presented with right homonymous inferior quadrantanopsia from the mass effect of a solitary cerebral metastasis from an invasive mole. A magnetic resonance image (MRI) of the brain showed a metastatic tumor in the left occipital lobe. The visual field improved slightly after chemotherapy. There was a reduction in the tumor size and the surrounding edema. This is the first case report demonstrating that homonymous quadrantanopsia should be included in the manifestations of the metastasis of an invasive mole.

Conclusions

The presentation of homonymous quadrantanopsia must alert ophthalmologists to conduct a complete medical history and arrange specialist consultation.

【 授权许可】

   
2012 Song et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Zhang X, Kedar S, Lynn MJ, Newman NJ, Biousse V: Homonymous hemianopias: clinical-anatomic correlations in 904 cases. Neurology 2006, 66:906-910.
• [2]Lurain JR, Brewer JI: Invasive mole. Semin Oncol 1982, 9:174-180.
• [3]Lurain JR: Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J Obstet Gynecol 2010, 203:531-539.
• [4]Evans AC Jr, Soper JT, Clarke-Pearson DL, Berchuck A, Rodriguez GC, Hammond CB: Gestational trophoblastic disease metastatic to the central nervous system. Gynecol Oncol 1995, 59:226-230.
• [5]Newlands ES, Holden L, Seckl MJ, McNeish I, Strickland S, Rustin GJ: Management of brain metastases in patients with high-risk gestational trophoblastic tumors. J Reprod Med 2002, 47:465-471.
• [6]Rampini P, Alimehmeti R, Egidi M, Locatelli M, Zavanone M: Left quadrantanopsia caused by traumatic subclavian steal syndrome. J Trauma 2004, 56:1342-1344.
• [7]Donzis PB, Factor JS: Visual field loss resulting from cervical chiropractic manipulation. Am J Ophthalmol 1997, 123:851-852.
• [8]Gomez CR, Bhat MH, Chung HD: Homonymous quadrantic visual field defect resulting from vertebrobasilar insufficiency: report of a case. Angiology 1990, 41:151-155.
• [9]Smith JL: Homonymous hemianopia. A review of one hundred cases. Am J Ophthalmol 1962, 54:616-623.
• [10]Groom M, Kay MD, Vicinanza-Adami C, Santini R: Optic tract syndrome secondary to metastatic breast cancer. Am J Ophthalmol 1998, 125:115-118.
• [11]Baehring JM, de Lotbiniere A, Bannykh S: Heteronymous inferior quadrantanopsia from a hypothalamic metastasis. J Neurooncol 2005, 75:345-346.