Third Ventricular Ependymoma Mimicking Foster Kennedy Syndrome- A Case Report

Aims: To report a case of a third ventricular tumour mimicking Foster Kennedy Syndrome in a young adult.

Presentation of Case: A 21-year-old female presented with bilateral blurring of vision with preceded by generalized headache, nausea and vomiting. Fundoscopy revealed optic nerve atrophy of the right eye and a swollen optic disc on the left in keeping with features of Foster Kennedy Syndrome. MRI of the brain revealed a third ventricular tumor extending into the suprasellar region with hydrocephalus. Surgical excision of the tumour was done and the subsequent histopathological report confirmed it to be a clear cell ependymoma.

Discussion: Foster Kennedy syndrome is a rare clinical constellation describing a pattern of ocular findings typically related to extraaxial tumours involving the anterior skull base. It is characterized by the triad of unilateral optic disc swelling, contralateral optic atrophy and ipsilateral anosmia. The clinical signs of Foster Kennedy syndrome are a result of direct compression of the mass on the optic nerve and an indirect effect from raised intracranial pressure.

Conclusions: We conclude from this report that intraventricular or intraaxial lesions in the vicinity of the optic apparatus may also produce features mimicking Foster Kennedy syndrome in clinical practice.