Case of the Week Archive
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2University of British Columbia, Vancouver, British Columbia, Canada
An 18-year-old man has a history of medulloblastoma detected in 2010. He received radiation therapy postexcision and developed recurrence in the form of dural metastasis along the left sphenoid wing in 2016, which was managed with chemotherapy and consolidation irradiation. In 2020, the patient presents with left-sided headache for 2 months and left temporal swelling for 1 month.
A 62-year-old woman with no relevant past medical history presents with several weeks of progressive left-sided facial pain.
A 59-year-old man with no pertinent past medical history presents to the emergency department after being found unresponsive, presumed secondary to opioid ingestion.
A 64-year-old man presents with a history of progressive painless swelling of the face and nasal blockade for 1 year duration.
A 17-year-old adolescent girl with no significant past medical history presents with worsening paroxysmal frontal headaches, nausea, and vomiting of 2 months' duration.
A 10-year-old boy with no past medical history presents with seizure-like activity for the past 2 months.
A 53-year-old man, smoker for 30 years, presents with an ulceroproliferative growth inside his mouth on the left cheek for the past 6 months. An incidentally detected lesion is seen on the floor of mouth during preoperative contrast-enhanced CT of neck.
A young woman presents with 1 month of blurry vision and intermittent headaches. She is hypertensive (BP 230/130). Fundoscopic examination shows bilateral blurred disc margins, cotton wool spots, macular edema, mild arteriole attenuation, hemorrhages, and choroidal infarcts. Neurologic exam notes poor visual acuity, red color desaturation, and symmetric hyperreflexia. Initial blood tests reveal elevated BUN and creatinine. All serum autoimmune tests and CSF are normal. She improves after treatment.