Recurrent Optic Neuropathy Caused by a Mucocele of the Anterior Clinoid Process after a 5-Year Remission: A Case Report and Literature Review

Abstract

A 32-year-old male presented with acute left vision loss during a second recurrence of optic neuropathy. Steroid pulse therapy had been effective in both the first episode 9 years previously and the first recurrence 5 years previously. Magnetic resonance imaging demonstrated an anterior clinoid process mucocele compressing the optic nerve. Although surgical treatment was performed, improvement was limited. This report indicates that steroid pulse therapy could be an alternative treatment to obtain temporary remission, but surgical treatment should be considered to prevent irreversible neurological deficits. This paper also presents a review of the literature on anterior clinoid process mucoceles.

Anterior Clinoid Metastasis as First Presentation of a Signet Ring Cell Carcinoma: An Intriguing Diagnosis

“…In our case, visual defects were the only presenting signs of an undiagnosed, silent primary tumor; this has made the diagnosis of metastasis for the lesion of the ACP more troublesome. Neuroradiological findings allowed us to exclude common ACP lesions, such as meningiomas and mucoceles, 5 13 14 favoring the hypothesis of an osseous neoplastic lesion. Indeed, extradural meningiomas are extremely rare, while mucoceles appear as expansile lesions with variable signal on T1- and T2-weighted images (depending on protein concentration) and are characterized by a peripheral linear enhancement.…”

“…The anterior clinoid process (ACP) may be affected by several pathological entities, being meningiomas the most common. 1 2 3 4 5 6 7 8 9 10 11 Usually, patients harboring ACP lesions present with visual or oculomotor defects because of the involvement of optic nerve, superior orbital fissure, and/or cranial nerves in the cavernous sinus. Anterior clinoidectomy along with tumor removal is the treatment of choice, either performed intra- or extradurally.…”

Anterior Clinoid Metastasis Removed Extradurally: First Case Report

“… 1 2 There are 11 different pathological entities described so far on the ACP other than meningioma ( Table 1 ). 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33…”