A Case of Secondary Carcinomatous Infiltration of the Pia-Arachnoid of the Brain, Presenting Exclusively Ocular Symptoms During Life: Meningitis Carcinomatosa

WHILE the occurrence of secondary deposits in the brain in cases of visceral carcinoma is well recognized, yet when this secondary involvement takes the unusual form of a fine microscopic infiltration of the lepto-meninges, the clinical and pathological problems involved become of some interest.The clinical feature which has seemed to justify the recording of the present case was that during life the physical signs were exclusively ocular, whereas commonly this form of carcinomatous involvement of the central nervous system produces a clinical picture akin to that of an acute meningitis.Pathologically, though this is not unique in the condition under consideration, the case is of interest because the lesion was so fine as almost entirely to escape notice on naked eye examination of the brain.Indeed, its nature and extent were not revealed until microscopic investigation was undertaken.As long ago as 1888, Oppenheim(3) referred to.certain cases of visceral carcinoma .inwhich striking symptoms referable to the nervous system appeared in the terminal stages of the disease, copyright.