Rapid onset of blindness due to meningeal carcinomatosis from an oesophageal adenocarcinoma. Issue 792 (October 1991)

• Record Type: Journal Article
• Authors: Teare, J. P.; Whitehead, M.; Rake, M. O.; Coker, R. J.
• Is Part Of: Postgraduate medical journal. Volume 67:Issue 792(1991)
• Page Start: 909
• Page End: 911
• Publication Date: 1991-10
• Subjects: Medicine -- Periodicals; 610
• DOI: 10.1136/pgmj.67.792.909
• Languages: English
• ISSNs: 0032-5473

Abstract

Abstract : 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.