Papilledema and Infiltrative Optic Neuropathy as Presenting Signs of Medulloblastoma

Abstract

This report demonstrates that bilateral papilledema and infiltrative optic neuropathy can be the only initial presenting signs of a medulloblastoma. A 23-year-old man had no cerebellar signs and no lesions on MRI to suggest such a tumor. His cerebrospinal fluid cytology was inconclusive. Progression of his disease was so rapid that postmortem biopsy of the affected optic nerves and cerebellum with immunohistochemical staining for neuronal marker proteins established the diagnosis of disseminated medulloblastoma. Disseminated medulloblastoma has a poor prognosis especially when tumor cells spread to the optic nerves.

KEYWORDS:

• Infiltrative optic neuropathy
• papilledema
• medulloblastoma