A Rare Case of Secondary Pseudotumor Cerebri Syndrome in a Female with a Tongue Base Tumor: A Case Report

INTRODUCTION: The pseudotumor cerebri syndrome (PTCS) is characterized by elevated intracranial pressure in the absence of intracranial structural lesions, with normal cerebrospinal fluid. PTCS may be primary, also known as idiopathic intracranial hypertension (IIH), or secondary to an identifiable cause such as obstructive sleep apnea (OSA). Primary and secondary PTCS share similar clinical features.

CASE PRESENTATION: We report the case of a 43-year-old female of normal weight initially suspected of IIH, who was subsequently diagnosed with secondary PTCS caused by a tongue base tumor, leading to OSA. She presented with symptoms consistent with PTCS, including headache, transient visual obscurations, and progressive visual decline. Fundoscopy revealed severe bilateral papilledema, and lumbar puncture showed an opening pressure of 43 cm H2O. Despite treatment with acetazolamide, her vision worsened, and optic nerve sheath fenestration was performed. Further investigation identified OSA caused by a benign tumor of the tongue as the underlying etiology. Following continuous positive airway pressure therapy her headache and papilledema resolved.

CONCLUSION: The case illustrates the importance of thorough search for secondary causes in patients diagnosed with PTCS.