Cerebral metastasis presenting with altitudinal field defect

A 75-year-old man presented with a unilateral inferior altitudinal visual f ield defect and a history of weight loss and night sweats. The acuity in th e affected eye was 20/200, otherwise his ocular examination was normal. Neu roimaging demonstrated a post-fixed chiasm, with a frontal metastasis compr essing the intracerebral portion of the optic nerve. A chest x-ray showed c lassical cannon ball lesions, secondary to malignant melanoma. This is the first case report of an intracerebral tumor producing an inferior altitudin al field defect.