Mbekeani Joyce N, Haseeb Mohammed Q, Tulbah Asma M, Hamed Salem H, Al Hazzaa Selwa A, Dogar Mohammad A
Department of Ophthalmology (JNM), North Bronx Health Network; Department of Ophthalmology & Visual Sciences (JNM), Albert Einstein College of Medicine of Yeshiva University, Bronx, New York; Departments of Ophthalmology (MQH, SAAH), Pathology (AMT), Gynecologic Oncology (SHH), and Neuro-radiology (MAD), King Faisal Specialist Hospital, Riyadh, Saudi Arabia; and the Al Faisal University College of Medicine (SAAH), Riyadh, Saudi Arabia.
J Neuroophthalmol. 2015 Jun;35(2):162-4. doi: 10.1097/WNO.0000000000000236.
Signet ring cell adenocarcinoma has a propensity for leptomeningeal carcinomatosis, and although bilateral optic nerve involvement is rare, this may occur with or without obvious signs of diffuse leptomeningeal involvement. We describe a 41-year-old woman who presented with a brief history of simultaneous bilateral visual deterioration and a distended abdomen. Examination revealed bilateral no light perception vision and bilateral optic disc edema. Radiologic work-up showed large multiple pelvic masses involving the ovaries, multifocal boney deposits, and widespread central nervous system carcinomatosis, involving the optic nerves and the first, fifth, and eighth cranial nerves. Biopsy of an ovarian mass demonstrated islands of signet ring cells. Signet cell adenocarcinomatous infiltration of the leptomeningeal space should be considered in cases of bilateral simultaneous vision loss with signs suggestive of leptomeningeal infiltration of the optic nerve sheath.
印戒细胞腺癌易于发生软脑膜癌病，虽然双侧视神经受累罕见，但可在有或无明显弥漫性软脑膜受累体征的情况下发生。我们报告一名41岁女性，有同时双侧视力减退和腹部膨隆的简短病史。检查发现双侧无光感视力及双侧视盘水肿。影像学检查显示多个累及卵巢的盆腔大肿块、多灶性骨转移及广泛的中枢神经系统癌病，累及视神经及第Ⅰ、Ⅴ、Ⅷ颅神经。卵巢肿块活检显示印戒细胞岛。对于双侧同时视力丧失且有提示视神经鞘膜软脑膜浸润体征的病例，应考虑印戒细胞腺癌浸润软脑膜间隙。
