A Case of Advanced Non-small Cell Lung Cancer with Visual Impairment due to Dural Metastasis

Endoscopic Endonasal Approach for Optic Canal Dural Metastasis in a Patient with Progressive Visual Dysfunction: A Case Report

“…Intracranial dural metastases are rare, accounting for approximately 5% of all metastatic brain tumors. 2 , 3 ) In a systematic review of 227 cases of ocular or orbital region metastases, the incidence of metastases to the optic nerve or optic sheath was 1.3%. 4 ) Thus, no treatment strategy has been established for such metastases.…”

“… 1 ) In the third case, the metastasized tumor was located on the dura near the anterior clinoid process; the tumor was subjected to radiotherapy and treated with osimertinib (80 mg/day), an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor. 2 ) Recently, osimertinib has emerged as a promising treatment alternative for patients with nonsmall cell lung cancer with EGFR mutation, an oncogenic driver of this disease. This is attributed to its ability to effectively penetrate the blood-brain barrier, making it a viable treatment option for intracranial tumors.…”

“…However, endonasal surgery is considered adequate for lesions in the inferomedial part of the optic canal. Although few studies have reported metastatic tumor removal around the optic nerve via the transcranial approach, 1 , 2 ) no studies have discussed endonasal approaches. The surgical strategy for metastatic tumors is to avoid irreversible brain or nerve dysfunction and improve visual function.…”

“…If the tumor exerts pressure on the optic nerve, early decompression via surgery may improve visual function. 1,2) This report describes a patient with rapid and progressive visual dysfunction due to a metastatic tumor on the inferomedial side of the optic canal region.…”