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Review
. 2020 Aug;68(8):1696-1698.
doi: 10.4103/ijo.IJO_2256_19.

Atypical optic neuritis as the presenting feature of testicular malignancy: Rare case report with review of literature

Anju Meena  1 , Harinder S Sethi  1 , Mukesh Joshi  2 , Mayuresh Naik  2
Affiliations
Review

Atypical optic neuritis as the presenting feature of testicular malignancy: Rare case report with review of literature

Anju Meena et al. Indian J Ophthalmol. 2020 Aug.

Abstract

A 23-year-old male presented with unilateral acute onset, painless, progressive diminution of vision. Initial clinical and radiological findings were consistent with optic neuritis. The patient was started on pulse steroids leading to visual recovery. However, the patient relapsed within one week. Repeat imaging revealed metastatic lesions near the orbital apex. Orbit is an unusual site of metastasis from testicular tumors and only 3 cases of testicular synovial sarcoma with orbital metastasis have been reported. A thorough systemic evaluation should be done in cases of atypical and relapsing optic neuritis to rule out the causes of optic neuritis (ON) masquerade syndrome.

Keywords: Atypical optic neuritis; pulse steroids; testicular synovial sarcoma.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Fundus photograph showing blurring of disc margins, disc hyperemia with peripapillary congestion
Figure 2
Figure 2
(a) (T1-weighted sagittal MRI showing) and (b) (T2-weighted sagittal MRI showing): Altered signal intensity lesions involving the right orbital apex encasing the right optic nerve in the optic canal and extending into the sphenoid sinus and posterior ethmoidal air cells
Figure 3
Figure 3
CECT spine showing lytic lesions involving the vertebral body, along with heterogeneously enhancing soft tissue lesion around L2 extending into bilateral psoas muscles
Figure 4
Figure 4
Histopathological H and E slide depicting testicular synovial sarcoma
See this image and copyright information in PMC

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