Article Text
Summary
An 83-year-old man, a prostate cancer survivor of 10 years with multiple vertebral metastases presented with sudden onset of double vision. On examination he was found to have an isolated partial left abducens palsy with no other neurological deficits. Despite having microvascular risk factors, given his history of prostate cancer, aMRI brain scan was requested to look for a neurological cause. The scan revealed a metastatic lesion in the clivus encasing the cavernous sinus and carotid artery. He was referred to his oncologist for further management, however he opted out of further treatment and succumbed to his illness a month later. This case report includes a literature review of cases with clivus metastases secondary to prostate cancer. It highlights the importance of carefully examining eye movements and having a high index of suspicion for the subtlest sign that may suggest brain metastases in elderly patients with prostate cancer with prolonged survival.
- prostate cancer
- neuroopthalmology
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Footnotes
Contributors VL: designing of the framework of the case review; acquisition including literature review, analysis and interpretation of data; revised all data critically for important intellectual content; provided final approval of the report to be published and agrees to be accountable for all aspects of the work. TP: case report selection; acquisition, analysis and interpretation of the data; allocating specific search value for case review; drafting the work; provided final approval of the version to be published and agrees to be accountable for all aspects of the work.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.