A rare cause of visual loss in AIDS patients: central retinal vein occlusion.

Comment The association of intracranial cartilaginous tumour and Ollier's disease is rare and there are only a handful of similar cases published. Chondromas and chondrosarcomas usually arise from the skull base and are located in the middle cranial fossa. Sarwar2 reported a patient with Ollier's disease presenting with diplopia and impaired vision due to chondroma arising from the sphenoid. Horizontal diplopia was also the presenting symptom in the cases reported by Traflet et al and Reuter and Weber.4 The patient in the latter report also suffered severe ipsilateral headache associated with nausea and vomiting and paraesthesias in the distribution of the trigeminal nerve. These features are obviously comparable to the case we report. Pospiech and coauthors5 reported a sellar chondroma associated with Ollier's disease presenting as a chiasmatic syndrome. This patient had head pain, vomiting, and visual failure. The main differential diagnosis in the reported case was meningioma although the relatively avascular tumour appearance on carotid angiography was against this. When the tumour contains calcification craniopharyngioma must be considered and when positioned more posteriorly (clivus/cerebellopontine angle) radiological differentiation from chordoma may be difficult.2 Our patient was treated by complete surgical tumour removal with no radiological evidence of recurrence to date. Surgery is the mainstay of treatment in these tumours which are not considered chemosensitive or radiosensitive.6