|LETTER TO THE EDITOR
|Year : 2020 | Volume
| Issue : 3 | Page : 128
Tuberous sclerosis and foramen of Monro
Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
Department of Neurology; Department of Medicine, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
|Date of Submission||15-Dec-2019|
|Date of Acceptance||03-Jun-2020|
|Date of Web Publication||4-Dec-2020|
Jamir Pitton Rissardo
Rua Roraima, Santa Maria, Rio Grande do Sul
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Rissardo JP, Fornari Caprara AL. Tuberous sclerosis and foramen of Monro. J Clin Ophthalmol Res 2020;8:128
We read the article entitled “Ophthalmic manifestations of tuberous sclerosis: A diagnostic clue” on the esteemed “Journal of Clinical Ophthalmology and Research” with great interest. Dhiman et al. reported a case of a young adult female who presented with headache was referred to the eye outpatient department for fundus examination, with a possibility of intracranial space-occupying lesion near foramen of Monro. On ophthalmologic examination, retinal astrocytoma was observed. After a thorough clinical examination, the subject was diagnosed with tuberous sclerosis.
Tuberous sclerosis is considered a phakomatosis, which refers to a group of neuro-oculo-cutaneous syndromes or neurocutaneous disorders involving structures arising from the embryonic ectoderm. It is a genetic disorder that affects multiple systems. In this context, multiple retinal hamartomas and retinal achromic patches are commonly ophthalmic abnormalities seen in this group of patients.
Here, we would like to highlight some of the differential diagnosis of the masses localized already reported in the foramen of Monro. The foramen of Monro is also known as interventricular foramina and communicates the lateral ventricles with the third ventricle. Further, this foramen has clinical significance when it is obstructed causing noncommunicating obstructive hydrocephalus. The majority of the reports are associated with infections TORCH related in the foramen region, leading to stenosis and obstruction.
Colloidal cyst is the most common mass in association with the foramen of Monro. Other common reported are the masses from the ependymal tissue that include subependymal giant cell tumors associated with tuberous sclerosis complex and subependymal nodules and hamartomas. The three described above are the most frequently encountered and well-known association. However, aneurysms, atresia, metastasis, pituitary adenoma, lymphoma, glioma, and neurocysticercosis were rarely reported in the literature. Even though these lesions may be differentiated by their specific characteristics, sometimes, it is difficult to clearly define them and the stereotactic biopsy should be done.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Dhiman R, Prashar A, Sharma RK, Tomar M, Yadav N. Ophthalmic manifestations of tuberous sclerosis: A diagnostic clue. J Clin Ophthalmol Res 2019;7:130-4. [Full text]
Zamora EA, Aeddula NR. Tuberous sclerosis. Treasure Island, FL: StatPearls Publishing; 2020.
Tubbs RS, Oakes P, Maran IS, Salib C, Loukas M. The foramen of Monro: A review of its anatomy, history, pathology, and surgery. Childs Nerv Syst 2014;30:1645-9.
Glastonbury CM, Osborn AG, Salzman KL. Masses and malformations of the third ventricle: Normal anatomic relationships and differential diagnoses. Radiographics 2011;31:1889-905.
Nishio S, Morioka T, Suzuki S, Fukui M. Tumours around the foramen of Monro: Clinical and neuroimaging features and their differential diagnosis. J Clin Neurosci 2002;9:137-41.