Bilateral optic disc edema as the presenting sign of brain metastasis

To report a rare case of bilateral optic disc edema as a presentation of brain metastasis. Case report. A 51-year-old healthy woman presented with complaints of headache, diplopia, and distortion of peripheral vision for the past one month. Examination of both the eyes showed massive optic disc edema, multiple radial hemorrhages, hard exudates at the disc margin, and absent venous pulsation. Magnetic resonance imaging (MRI and MRA) showed leptomeningeal enhancement with raised intracranial pressure: a sign of metastasis. She had undergone mastectomy and had received eight cycles of systemic chemotherapy and radiation for breast carcinoma two years ago. She was urgently referred to an oncologist for further management. This case highlights the importance of neuroimaging in patients presenting with bilateral disc edema and prior history of breast carcinoma to rule out metastasis.