An asymptomatic 42-year-old man was admitted for review of his 3-year history of type II diabetes.
In the physical examination the corrected visual acuity was 1.0 in both eyes.
The anterior pole was normal and the intraocular pressure was 16 mmHg in both eyes.
Intrinsic motility was normal.
Indirect endoscopy showed a right optic nerve with band or in «pajarita» and left papilla which was described as pale; there were no signs of diabetic foot disease.
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A visual field (Humphrey 30-2 test Allergan Humphrey, San Leandro, California, USA) was performed, where a right hemianopsia was observed.
Intracranial computed tomography (CT) scan of the brain showed a 2 cm diameter calcification in relation to the left amygdala and hippocampal head.
Brain MRI showed a heterogeneous lesion in the head of the left hippocampus, with calcification and an adjacent hemorrhagic area.
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The color test was normal.
In the cerebral arteriography and preoperative vascular mapping, the patient had an allergic reaction to contrast with cutaneous manifestations, which resolved after treatment with antihistamines.
A craniotomy was performed and the lesion was completely resected.
The pathological study of the same revealed a subepidemoma.
The definitive diagnosis was left ventricular subepidemoma of the temporal horn with retrochiasmatic involvement and optic disc in the left band.
In the last exploration it continues without changes, maintains right hemianopsia confection in the campimetry, the optic nerves with the same degree and the rest of the exploration is normal.
