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   Table of Contents      
CASE REPORT
Year : 1989  |  Volume : 37  |  Issue : 3  |  Page : 152-153

Intracranial extension of orbital meningioma-A case report


Neuro-opthomology. Section, Dept. Ophthalmology SCB Medical College, Cuttack - 753007, India

Correspondence Address:
Madhumati Misra
Neuro-opthomology. Section, Dept. Ophthalmology SCB Medical College, Cuttack - 753007
India
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Source of Support: None, Conflict of Interest: None


PMID: 2632455

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How to cite this article:
Misra M, Mohanti AB, Rath S. Intracranial extension of orbital meningioma-A case report. Indian J Ophthalmol 1989;37:152-3

How to cite this URL:
Misra M, Mohanti AB, Rath S. Intracranial extension of orbital meningioma-A case report. Indian J Ophthalmol [serial online] 1989 [cited 2019 Dec 8];37:152-3. Available from: http://www.ijo.in/text.asp?1989/37/3/152/26062


  Introduction Top


Primary orbital meningiomas are rare and arise from the optic nerve sheath [1],[2],[3]. Intracranial meningioma from the sphenoidal wing or tuberculum sellae commonly invade the orbit. Cranial extension of a primary orbital meningioma is extremely rare and has not yet been reported. In the present case, a primary orbital meningioma was decompressed via frontal craniotomy and excision of the orbital roof. Subsequently, intracra­nial extension of the orbital meningioma occurred through the excised orbital roof and presented diagnos­tic difficulty. Rarity of this case prompted this case report.


  Case report Top


KD, a 30 year old female presented in the neuro-ophthal­mic section, of SCB Medical College Hospital, Cuttack in august,1986 with left axial proptosis. Orbital computed tomographic (CT) scan showed a left retrobulbar space occupying lesion engulfing the optic nerve. The left eye had 6/24 and right eye 6/6 vision with normal optic fundi. Left frontal craniotomy was done and the tumour was removed after excision of the left orbital roof. Bi­opsy of the tumour showed meningioma.

She was readmitted in August,1987 for reappearance of left proptosis, headache, vomiting, papilloedema, and right hemiparesis [Figure - 1] CT scan demonstrated subfron­tal extension of the orbital meningioma through the excised orbital roof. Left cerebral angiography showed intracranial extension of the orbital mass [Figure - 2]. The frontal and orbital tumours could be removed in one sitting through a left frontal craniotomy and orbital roof reconstruction with fascia lata was done. Proptosis regressed and features of intracranial extension disap­peared after surgery.


  Discussion Top


Meningiomas account for 6 to 17 percent of diseases producing proptosis of the eye [2][3] This tumour is fre­quent in the fourth and fifth decades but primary orbital meningiomas are found in the first and second decade [1],[2],[3]. There is greater preponderance in females, in the order 2 :1[2].

Meningiomas arise from the arachnoid cell caps over the arachnoid villi [2],[4],[5],[6].[7]. Primary orbital meningiomas are rare and arise from the dural lining of the optic nerve. They may arise from the perineurium of the orbital peripheral nerves [2],[4].

Intracranial meningiomas of the greater and lesser wing of the sphenoid cause proptosis by direct encroachment on the orbital cavity, by reactive hyperostosis of the inner orbital wall or by interfering with venous or lym­phatic drainage [6]. Classical optic nerve meningiomas present proptosis without ophthalmoplegia, visual fail­ure, optic atrophy or papilloedema [3]

In the present case, cranial extension of the orbital meningioma occurred through the previously surgically excised orbital roof and was demonstrated by CT scan. Timely surgery saved the life.

 
  References Top

1.
Mac Michael I. M. and Cullen J F. Brit. J. Ophthalmol, 53, 169, 1969.  Back to cited text no. 1
    
2.
Reese AB, -Trans Ophthal Soc. UK. 91.85, 1971.  Back to cited text no. 2
    
3.
Housepian EM, Trokel SL Tumours of the Orbit in Youmans J R Edn, Youmans Neurological Surgery, Philadephia, Saunders Company pub. Vol. 5, 2nd Edn. P g. 3046, 1983.  Back to cited text no. 3
    
4.
Russell DS, Rubinstein LT. Pathology of tumours of the nervous systems. Edward Arnold Ed. London. 76, 1977.  Back to cited text no. 4
    
5.
Misra M. Rath, Orissa Medical Journal (In press), 1987.   Back to cited text no. 5
    
6.
Rao B. Dinakar S, Rao IS Neurology India, 35, 748, 1971.   Back to cited text no. 6
    
7.
Roy T. K. Neurology India, 33.61, 1985.  Back to cited text no. 7
    


    Figures

  [Figure - 1], [Figure - 2]



 

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