Testicular Seminoma Presenting with Bilateral Blindness: Looking Beyond the Eye

Abstract

Cancer-associated retinopathy (CAR) is a rare cause of vision loss that was first reported in 1976. It is reported that the retinopathy associated with cancer occurs due to antibodies against the tumor antigens that cross-react with retinal cell layers. We present the case of a young male who came to the emergency department with sudden onset of bilateral vision loss. He had a large-sized testicular seminoma with metastatic retroperitoneal lymphadenopathy. Several primary ophthalmological and systemic conditions were considered. He had multiple, positive anti-retinal antibodies. The cancer was felt to be the cause of the vision loss based on the clinical presentation and the presence of anti-retinal antibodies. He was treated with intravenous steroids, plasmapheresis, and curative chemotherapy, but there was no improvement in vision. Unfortunately, he died due to multiorgan failure. Our case is the second on seminoma-associated retinopathy in the literature.

Ocular Paraneoplastic Syndromes: A Critical Review of Diffuse Uveal Melanocytic Proliferation and Autoimmune Retinopathy

“…The results have been mixed in terms of short-term outcomes. 71,81-105 Since 2012, there have been 40 cases reported with extractable information (Table, supplement). Among those patients, 25 (62.5%) had more than 3 months of follow-up.…”