Primary intraorbital meningioma

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MENINGIOMAS comprise 14 percent of all intracranial tumors.1 They are almost exclusively intracranial in origin and location, and only rarely arise primarily within the orbit.2, 3 The large majority of intraorbital meningiomas are secondary, extending into the orbit from a primary intracranial site.4

Primary intraorbital meningiomas can be classified into two groups—those attached to the optic nerve sheath, and those not attached to the nerve sheath; those with no sheath attachment and lying outside the muscle cone are extremely rare.2, 3 The case reported here is of a meningioma of the latter, rare type.

Report of a case

A 55-year-old, right-handed woman was examined at the Cleveland Clinic in December 1968 because of gradual protrusion of her right eye without visual impairment. Three weeks before the examination she had noticed sudden increase in the protrusion which was associated with dull, throbbing pain. There was no diplopia. In 1967 the patient had been examined by an ophthalmologist who advised surgical treatment for a suspected intraorbital tumor.

Examination. Except for the eyes, results of the neurologic examination were normal. There was proptosis and deviation of the right eye forward and downward. A firm mass was palpable between the supraorbital rim of the right orbit and the globe. The right upper lid was edematous. Eye movements were normal except for the inability to elevate the right eye. Exophthalmometer measurements were 28 mm for the right eye and 19 mm for the left eye. Visual fields, tonometry, and ophthalmoscopic findings were normal. Visual . . .



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