DR.UMA M

DR. VIRNA SHAH

Abstract

We report a rare case of 51year old male with H/O prostate carcinoma on treatment for 3 years.He presented with sudden onset of defective vision LE for 1 week.On examination, his BCVA in RE 6/6 & LE 6/60 with Grade 4 RAPD.BE fundus was normal. VEP showed reduced amplitude & increased latency in LE.Neuroimaging showed thick pachymeningeal enhancement & multiple lesions s/o cerebral metastasis with mild hyperintensity of left optic nerve s/o compressive or ischemic optic neuropathy.Patient was advised to review with oncologist.90% of prostate cancer metastases to spinal cord.Brain metastasis is rare & occurs late in course of disease.Metastasis to dura & adjacent parenchyma occurs in 1-2%.Common intracranial sites are leptomeninges (67%),cerebrum(25%), cerebellum(8%).Brain metastasis is usually associated with poor prognosis & 1year survival rate is 18%.This case is presented to emphasize the need to take a thorough history & to suspect metastasis to brain even in prostate carcinoma.