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Spheno-Orbital Meningioma and Vision Impairment—Case Report and Review of the Literature

(1) Background: Spheno-orbital meningioma (SOM) is a very rare subtype of meningioma which arises from the sphenoid ridge with an orbital extension. It exhibits intraosseous tumor growth with hyperostosis and a widespread soft-tissue growth at the dura. The intra-orbital invasion results in painless...

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Autores principales: Wierzbowska, Joanna, Zegadło, Arkadiusz, Patyk, Michał, Rękas, Marek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821601/
https://www.ncbi.nlm.nih.gov/pubmed/36614875
http://dx.doi.org/10.3390/jcm12010074
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author Wierzbowska, Joanna
Zegadło, Arkadiusz
Patyk, Michał
Rękas, Marek
author_facet Wierzbowska, Joanna
Zegadło, Arkadiusz
Patyk, Michał
Rękas, Marek
author_sort Wierzbowska, Joanna
collection PubMed
description (1) Background: Spheno-orbital meningioma (SOM) is a very rare subtype of meningioma which arises from the sphenoid ridge with an orbital extension. It exhibits intraosseous tumor growth with hyperostosis and a widespread soft-tissue growth at the dura. The intra-orbital invasion results in painless proptosis and slowly progressing visual impairment. (2) Methods: We present a case of a 46-year-old woman with SOM and compressive optic nerve neuropathy related to it. Her corrected distance visual acuity (CDVA) was decreased to 20/100, she had extensive visual field (VF) scotoma, dyschromatopsia, impaired pattern-reversal visual-evoked potential (PVEP), and decreased thicknesses of the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC), measured with the swept-source optical coherence tomography (SS-OCT), and a pale optic nerve disc in her left eye. Brain CT and MRI showed a lesion at the base of the anterior cranial fossa, involving the sphenoid wing and orbit. Pterional craniotomy and a partial removal of the tumor at the base of the skull and in the left orbit with the resection of the lesional dura mater and bony defect reconstruction were performed. (3) Results: The histological examination revealed meningothelial meningioma (WHO G1). Decreased CDVA and VF defects completely recovered, and the color vision score and PVEP improved following the surgery, but RNFL and GCC remained impaired. No tumor recurrence was observed at a follow-up of 78 months. (4) Conclusions: Optic nerve dysfunction has the capacity to improve once the compression has been relieved despite the presence of the structural features of optic nerve atrophy.
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spelling pubmed-98216012023-01-07 Spheno-Orbital Meningioma and Vision Impairment—Case Report and Review of the Literature Wierzbowska, Joanna Zegadło, Arkadiusz Patyk, Michał Rękas, Marek J Clin Med Case Report (1) Background: Spheno-orbital meningioma (SOM) is a very rare subtype of meningioma which arises from the sphenoid ridge with an orbital extension. It exhibits intraosseous tumor growth with hyperostosis and a widespread soft-tissue growth at the dura. The intra-orbital invasion results in painless proptosis and slowly progressing visual impairment. (2) Methods: We present a case of a 46-year-old woman with SOM and compressive optic nerve neuropathy related to it. Her corrected distance visual acuity (CDVA) was decreased to 20/100, she had extensive visual field (VF) scotoma, dyschromatopsia, impaired pattern-reversal visual-evoked potential (PVEP), and decreased thicknesses of the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC), measured with the swept-source optical coherence tomography (SS-OCT), and a pale optic nerve disc in her left eye. Brain CT and MRI showed a lesion at the base of the anterior cranial fossa, involving the sphenoid wing and orbit. Pterional craniotomy and a partial removal of the tumor at the base of the skull and in the left orbit with the resection of the lesional dura mater and bony defect reconstruction were performed. (3) Results: The histological examination revealed meningothelial meningioma (WHO G1). Decreased CDVA and VF defects completely recovered, and the color vision score and PVEP improved following the surgery, but RNFL and GCC remained impaired. No tumor recurrence was observed at a follow-up of 78 months. (4) Conclusions: Optic nerve dysfunction has the capacity to improve once the compression has been relieved despite the presence of the structural features of optic nerve atrophy. MDPI 2022-12-22 /pmc/articles/PMC9821601/ /pubmed/36614875 http://dx.doi.org/10.3390/jcm12010074 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Wierzbowska, Joanna
Zegadło, Arkadiusz
Patyk, Michał
Rękas, Marek
Spheno-Orbital Meningioma and Vision Impairment—Case Report and Review of the Literature
title Spheno-Orbital Meningioma and Vision Impairment—Case Report and Review of the Literature
title_full Spheno-Orbital Meningioma and Vision Impairment—Case Report and Review of the Literature
title_fullStr Spheno-Orbital Meningioma and Vision Impairment—Case Report and Review of the Literature
title_full_unstemmed Spheno-Orbital Meningioma and Vision Impairment—Case Report and Review of the Literature
title_short Spheno-Orbital Meningioma and Vision Impairment—Case Report and Review of the Literature
title_sort spheno-orbital meningioma and vision impairment—case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821601/
https://www.ncbi.nlm.nih.gov/pubmed/36614875
http://dx.doi.org/10.3390/jcm12010074
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