Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Giant Intracranial Xanthoma with Blurred Vision as the First Symptom: A Case Report and Literature Review

Version 1 : Received: 5 November 2020 / Approved: 16 November 2020 / Online: 16 November 2020 (08:30:08 CET)

How to cite: Wang, X.; Li, X.; Liu, X.; Yin, Y.; Dang, Y.; Lei, F. Giant Intracranial Xanthoma with Blurred Vision as the First Symptom: A Case Report and Literature Review. Preprints 2020, 2020110397 (doi: 10.20944/preprints202011.0397.v1). Wang, X.; Li, X.; Liu, X.; Yin, Y.; Dang, Y.; Lei, F. Giant Intracranial Xanthoma with Blurred Vision as the First Symptom: A Case Report and Literature Review. Preprints 2020, 2020110397 (doi: 10.20944/preprints202011.0397.v1).

Abstract

A 31-year-old male noticed blurred vision in his right eye for five days with no obvious predisposing causes, accompanied by mild dizziness. No obvious nodular lesions were found in the body. The patient’s binocular visual acuity was 20/20. Fundus photography showed the optic nerve swelling and radial superficial retinal hemorrhage of both eyes. Blood panel, urine routine, liver, and kidney function were all normal. Total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein were all in the normal limits. Head MRI showed a mass in the right temporal lobe, clear boundary, and multiple separations, which thinned and disappeared closer to the skull. The right temporal lobe and lateral ventricle were all compressed, with the midline structure shifted to the left. The patient was then transferred to Neurosurgery. During the operation, we observed the tumor had invaded the skull. The actual size of the tumor was 5.6 cm × 7.5 cm × 10.1 cm. Histology revealed foam cell accumulation in the mucous connective tissue of the right temporal lobe. The immunohistochemistry showed: CD34 (+), CD99 (+), EMA (−), GFAP (−), IDH-1 (−), Ki-67 (+) index about 10%, Oliga-2 (−), PR (−), S-100 (−), Vim (+), β-Catenin (+), CD1a (−), CD68 (+). Three months after the removal of the tumor, the visual acuity of both eyes was 20/20; The visual fields were normal, the optic disc edema and retinal hemorrhages had disappeared. MRI indicated the midline structure was back to normal.

Subject Areas

intracranial xanthoma; vision; eye

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