Exophthalmia revealing a spheno orbital en-plaque meningioma: a case report

Author: Yosra Maalej (Tunisia)

Co-authors: Salma Gargouri, Takwa Sammouda, Omar Ayedi, Dorra Sallemi, Sonda Kammoun, Amira Trigui

Purpose

To report an unusual case of progressive exophtalmia revealing a spheno orbital en-plaque meningioma.

Setting/Venue

Department of Ophthalmology, Habib Bourguiba University Hospital, Faculty of Medicine, University of Sfax, Tunisia.

Methods

Case report.

Results

A 43-years-old woman with no previous medical history, presented with right eye proptosis evolving for two years with recent worsening, without diplopia or sight impairment. The ocular examination of the right eye shows a visual acuity at 10/10 ,equally reactive pupils and a proptosis that is scaled grade III, axile, painless, non-pulsatile and non reductible without any eye movement limitation. The intraocular pressure was normal in both eyes. The right eye fundus showed no abnormalities neither an optic nerve compression nor any choroid folds. A complete neurological examination was performed on the patient which was completely normal. The MRI scan shows a spheno orbital meningeal tumor highly in favor of an en-plaque meningioma. The patient was referred to the Neurosurgical department to undergo a surgical resection.

Conlusions

The intraossous meningioma is a variety of ectopic meningioma in which the meningo epithelial cells invade the bone wall and is responsible for hyperostosis. The en-plaque meningioma is a variant of intraossous meningiomas and is considered to be a rare tumor occurring in most cases in the spheno orbital area. Spheno orbital en-plaque meningiomas are known to be benign tumors with a progressive growth rate and are responsible for a painless and progressive exophtalmia.The surgical resection is the main treatment with high rates of recovery.

Financial Disclosure

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