Intraorbital Meningioma Extended to Intracranial Cavity: A Case Report.

Chang, Hyun Ki; Lim, Kyung Il; Park, Joong Wook; Chung, Hee Sung; Woo, Jung Hyun

Original Article

Journal of Korean Neurosurgical Society 1980;9(2): 471-478.

Hyun Ki Chang, Kyung Il Lim, Joong Wook Park, Hee Sung Chung, Jung Hyun Woo

Department of Neurosurgery, Chonnam University Medical School, Kwang-Ju, Korea.

ABSTRACT

A seventeen-year-old boy who had progressive visual disturbance and exophthalomos of the left side for several years, was admitted with complaints of headache and visual disturbance of the right eye. On admission, physical and neurological examinations were normal except remained thoracotomy scar on the right chest for removal of the mediastinal neurilemmoma. Ophthalmological examinations were as follows;Visual acuity was only light perception on the left and 20/40 on the right, exophthalmometry disclosed 17 mm on the left, 12 mm on the right, the fundoscopic examination revealed marked optic atrophy on the left eye. The superior oblique and lateral rectus muscles of the left eye were paralyzed. Plain skull X-ray showed hyperostosis of the anterior clinoid process and lesser wing of the sphenoid bone on the left side. Optic foramen view showed relative normal shape and size of both optic foramina, but marked hyperostosis of the left one was seen. CT scan showed increased density of round tumor mass on the left retrobulbar area and irregular shaped tumor attached to the anterior clinoid process and lesser wing of the sphenoid bone of the left side, which were strongly enhanced by contrast media. The left fronto-temporal craniotomy was performed. The yellowish-brown-colored nodular tumor was found in the parasellar region and lesser wing of the sphenoid bone of the left side. Under the operating microscope, removal of the tumor mass with left optic nerve resection was carried out. Post-operative course was uneventful and discharged on 20 th hospital day after the enucleation of the left eyeball by ophthalmologist.