ORBITAL SOCIETY

Meningioma - Sphenoid Wing Meningioma

Mengiomas of the orbit are benign growths that arise from the arachnoid villi (layer of the covering of the brain). More commonly, meningiomas of the orbit arise from orbital extension from an intracranial meningioma. However, depending on the location of the growth, meningiomas can cause eyeball protrusion, strabismus, and optic nerve compression. Mengiomas can be treated by surgical excision depending on its location, often with an orbital surgeon and neurosurgeon.

Optic nerve meningiomas are benign tumors of the optic nerve that are often more common in middle-age women.

Diagnosis

Orbital CT commonly shows hyperostosis (localized bone thickening) of the bone next to the meningioma. In optic nerve meningiomas, enlargement of the optic nerve sheath is seen on CT and MRI.

Management

Treatment of meningioma depends on the location. Meningiomas are generally resistant to radiation therapy or chemotherapy. Observation may be recommended if vision is not affected and without extension into the brain. If visual loss is significant or progressive, radiotherapy can be utilized. Rarely, surgical excision can be attempted in patients with optic nerve meningiomas with intracranial extension, severe visual loss and proptosis.

Types of common orbital tumors include:

Cancers:

• Lymphoma (primary cancer of the orbit that may involve the bone marrow)
  
• Metastasis (cancer from another part of the body seeding the orbit)
  
• Secondary cancers spreading from the adjacent structures (skin, sinus, or brain)

Non-cancers:

• Cavernous hemangioma (benign vascular tumor)
  
• Meningioma (benign neural tumor)
  
• Dermoid Cyst

 

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