Masquerade Syndrome: An Ocular Involvement of Lung Cancer

Masquerade Syndrome: An Ocular Involvement
Vol. 8 No. 1 : 2013 (47-51)

UMI KALTHUM MN UMI KALTHUM MN
WAN HASLINA WAH WAN HASLINA WAH

Abstract
We report a case of a 37-year-old smoker who presented with painless and sudden onset of loss of upper field vision of the right eye, associated with one month history of dry cough which was unresponsive to antibiotic and subsequent anti- tuberculosis therapy. Visual acuity at presentation was counting finger. There was bullous retinal detachment on examination. Radiological imaging revealed multiple lung opacities, involving the brain and the right orbit. Bronchoscopy and biopsy confirmed the diagnosis of adenocarcinoma of the lung. This case illustrates masquerade syndrome of which a lung carcinoma harbours behind a seemingly innocent retinal detachment. It also highlights the importance of entertaining lung carcinoma as a differential diagnosis in suspected tuberculosis among heavy smokers.
Keywords : adenocarcinoma, masquerade syndrome, retinal detachment, smoker,
Abstrak
Kami melaporkan kes seorang lelaki berusia 37 tahun yang merupakan seorang perokok, datang dengan kehilangan medan penglihatan sebelah atas mata kanan secara tiba-tiba tanpa kesakitan. Beliau juga melaporkan episod batuk kering yang tidak respon pada antibiotik dan juga anti-tuberkulosis. Penglihatan beliau hanya setakat mengira jari. Terdapat rekangan retina ‘bullous’ pada pemeriksaan. Pengimejan radiologi menunjukkan legapan pada peparu, otak dan mata kanan. Bronkoskopi dan biopsy mengesahkan kanser peparu. Kes ini menggambarkan kanser peparu yang ‘bersembunyi’ di sebalik rekangan retina. Ia juga menekankan kepentingan untuk melihat kanser peparu sebagai diagnosa tambahan bagi kes disyaki tuberkulosis di kalangan perokok.
Kata Kunci : kanser peparu, perokok, rekangan retina, sindrom ‘masquerade’,

Correspondance Address
Dr. Umi Kalthum Md Noh, Department of Ophthalmology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: 603-91455981 Fax: 603- 91456673 Email: umi_fizul@yahoo.com