[Optic nerve sheath meningioma with intraocular invasion--a case report]

In case a sonographically high reflective intraocular tumor is detected, some different processes with calcium embedding could be considered.

A 56 year-old female patient was seen in our department for the first time because of secondary glaucoma of the amaurotic right eye. The left eye has had no morphological changes and visual acuity was 5/5.

More than 20 years ago the patient had noticed decreased visual acuity of the right eye for the first time. 10 years ago in a first report from another eye hospital, a large white tumor in the area of the optic disc had been described. Sonographic size was 12 x 8 mm, 5.3 mm prominence. Visual acuity was perception of light with incorrect projection. A CT scan showed an inhomgeneous structure of calcification in the area of the right optic disc which continued along the optic nerve to intracranial structures. Enucleation was performed. Histopathological examination showed meningothelial meningeoma (grade I WHO) with its origin in the dural sheath of the optic nerve and intraocular growth. A postoperative MRI confirmed the intracranial spreading of the meningeoma along the dural sheath of the optical nerve. A meningeoma of the olfactorius region was found as a second independent tumor.

The intraocular spread of an optical nerve sheath meningeoma is a rare case.