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Case Reports
. 2021 Dec 31:25:101253.
doi: 10.1016/j.ajoc.2021.101253. eCollection 2022 Mar.

Metastatic paraganglioma presenting as ajunctional scotoma

Mohamed M Khodeiry  1   2 , John T Lind  3 , Joshua Pasol  1 , Byron L Lam  1 , Richard K Lee  1
Affiliations
Case Reports

Metastatic paraganglioma presenting as ajunctional scotoma

Mohamed M Khodeiry et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: To report a unique case of metastatic paraganglioma presenting as a junctional scotoma.

Observations: A 38-year-old Caucasian man with a history of abdominal paraganglioma presented with minimally blurred vision 20/25 visual acuity in the left eye. The patient was found to have a junctional scotoma upon visual field testing. Cranial MRI revealed a large peri-clival mass compressing the pre-chiasmal optic nerves and other loci of metastatic disease. Intracranial masses, including metastases, can present with a relatively intact central acuity and nonspecific visual symptoms.

Conclusions and importance: To the best of our knowledge, this is the first report of metastatic paraganglioma causing a junctional scotoma. In cases with junctional scotoma, careful neuro-ophthalmic assessment and imaging are of paramount importance, even in patients with excellent visual acuity.

Keywords: Junctional scotoma; Optic chiasm; Paraganglioma; Visual field defect.

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Conflict of interest statement

The authors have no relevant conflicts of interest to disclose with this manuscript.

Figures

Fig. 1
Fig. 1
Humphrey 24-2 Swedish Interactive Testing Algorithm fast visual fields showing a junctional scotoma, superior-temporal defect in the right eye and central scotoma in the left eye.
Fig. 2
Fig. 2
Coronal post contrast T1-weighted MRI scan showing large skull base mass compressing both prechiasmal optic nerves. Note the left sided skull metastatic lesion as well.
Fig. 3
Fig. 3
Axial post contrast T1-weighted MRI revealing a large mass within the ethmoids and skull base with displacement of the left medial orbital wall and obliteraion of both optic canals.
See this image and copyright information in PMC

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