Author: Federico Giannuzzi
Co-authors: Matteo Mario Carla, Francesco Boselli, Gloria Gambini, Tomaso Caporossi, Umberto De Vico, Stanislao Rizzo
Abstract
Purpose: To report a case of a 57-years-old female patient who presented with prominent bilateral proptosis and swollen hemorrhagic disks.Methods: Case report
Results: A 57-year-old obese patient admitted to our ophthalmic department complaining of bilateral sense of eye swelling and mild blurring vision. The anterior segment and pupillary reflex were normal on ophthalmological testing. Likewise, eye movements were preserved and she did not report diplopia in any position of gaze. Dilated fundus examination revealed bilateral hemorrhagic papilledema, pre-retinal hemorrhages in both eyes, dot and blot hemorrhages in the peripheral retina. Visual acuity was 20/20 in both eyes. Routine hematological investigations revealed increased both Von Willebrand factor and ristocetin factor and LAC positivity. The LP showed elevated cerebrospinal fluid (CSF) proteins. MRI with contrast of brain and spinal cord showed signs of intracranial hypertension and the presence of two lesions in continuity with each other respectively located at T12-L1 and L1-L2. Radiologic features were compatible with the diagnosis of schwannoma. A surgical procedure was conducted and confirmed the diagnosis after anatomical pathology analysis.
Conclusion: Although rare, bilateral hemorrhagic swollen disks could be an early sign of spinal cord tumors, such as schwannomas.
