Atypical orbital primary optic nerve sheath meningioma with severe disfiguring proptosis: an alternative surgical approach

  • Sylves Patrick Department of Ophthalmology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia https://orcid.org/0000-0001-9748-2760
  • Yeap Boon Tat Department of Anesthesiology and Intensive Care, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia
  • Muhamad Zarif Mohd Amin Department of Ophthalmology, Queen Elizabeth Hospital, Sabah, Malaysia
  • Maftuhim Addenan Department of Ophthalmology, Queen Elizabeth Hospital, Sabah, Malaysia
  • Shuaibah Ab.Ghani Department of Ophthalmology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia
  • Hanida Hanafi Department of Ophthalmology, Queen Elizabeth Hospital, Sabah, Malaysia; Oculoplastic and Reconstructive Unit, Department of Ophthalmology, Queen Elizabeth Hospital, Sabah, Malaysia
DOI: https://doi.org/10.13181/mji.cr.236936
Keywords: enophthalmos, esotropia, meningioma, ophthalmoplegia
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Abstract

Primary optic nerve sheath meningioma is generally a benign tumor. In rare instances, however, the growth rate and intraocular and intracranial extensions can be highly aggressive, especially in children, leading to poor prognosis. Here, we reported a case of a 24-year-old woman who presented with left eye swelling for 3 years. This was associated with blurred vision, retrobulbar pain, and redness. On examination, the left eye was severely proptosed with complete ophthalmoplegia. Magnetic resonance imaging showed an extensive tumor occupying the whole left orbital cavity with a disfigured eyeball. However, no intracranial extension was observed. Interestingly, complete surgical excision was feasible via transconjunctival anterior orbitotomy without bone removal. The histopathological examination confirmed the diagnosis of optic nerve sheath meningioma. Adjunct radiotherapy was given. On a follow-up after 2 years, left enophthalmos with esotropia was observed.

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Published
2023-11-01
How to Cite
1.
Patrick S, Tat YB, Amin MZM, Addenan M, Ab.Ghani S, Hanafi H. Atypical orbital primary optic nerve sheath meningioma with severe disfiguring proptosis: an alternative surgical approach. Med J Indones [Internet]. 2023Nov.1 [cited 2024May22];32(3):190-3. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/6936
Issue
Vol. 32 No. 3 (2023): September
Section
Case Report/Series

Copyright (c) 2023 Sylves Patrick, Yeap Boon Tat, Muhamad Zarif Mohd Amin, Maftuhim Addenan, Shuaibah Ab.Ghani, Hanida Hanafi

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