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September 1979

Chiasmal Syndrome due to Metastasis

Author Affiliations

From the Departments of Ophthalmology (Drs Cohen and Lessell), Anatomy (Dr Lessell), and Neurology (Dr Lessell), Boston University School of Medicine. Dr Cohen is now with the Department of Neurology, Medical College of Pennsylvania, Philadelphia.

Arch Neurol. 1979;36(9):565-567. doi:10.1001/archneur.1979.00500450059010

• We examined three patients with a chiasmal syndrome due to metastasis and were able to find only two additional cases in the literature. The characteristic presentation consisted of progressive impairment of vision without headache or abnormal plain skull x-ray films in patients with weight loss or diabetes insipidus. In three of the five patients, the primary malignant neoplasm was occult when symptoms and signs of chiasmal dysfunction were seen. Four patients responded well to irradiation. The chiasm may be compromised by suprasellar extension of pituitary metastasis, by infiltration from an infundibular or hypothalamic metastasis, or by hematogenous spread of tumor.