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Orbital Recurrence of Ethmoid Sinus Malignant Meningioma: Case Study and Literature Review
Leslie Neems1, Chambers Christopher
1*Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, and †Department of Ophthalmology, University of Washington, Seattle, Washington, U.S.A.
Abstract:
The authors describe a case of a recurrent World Health Organization grade III extradural, sinonasal meningioma that presented with epiphoria. Primary extradural meningiomas are rare, comprising only 1% to 2% of all meningiomas. These tumors are diagnosed and graded histologically according to the World Health Organization criteria. Grade III tumors are very malignant with high recurrence and death rates. This case highlights the rarity of sinonasal tract meningiomas involving the orbit. In addition, it shows the poor prognosis of such malignant disease and the need for a multidisciplinary approach. Collection and evaluation of protected patient health information for this report was in compliance with the Health Insurance Portability and Accountability Act and approved by the Institutional Review Board of Northwestern University Feinberg School of Medicine. Research adhered to the tenets of the Declaration of Helsinki.
Insights
A rare, aggressive sinonasal meningioma (World Health Organization grade III) recurred, causing epiphoria. This highlights the poor prognosis and need for a multidisciplinary approach in managing these malignant tumors.
Area of Science:
- Neuro-oncology
- Ophthalmology
- Otorhinolaryngology
Background:
- Primary extradural meningiomas are rare, accounting for 1-2% of all meningiomas.
- World Health Organization (WHO) grading classifies meningiomas histologically, with Grade III indicating high malignancy.
- Sinonasal tract meningiomas are uncommon, and orbital involvement further increases rarity.
Observation:
- A case of recurrent WHO Grade III extradural, sinonasal meningioma presented with epiphoria (excessive tearing).
- The tumor involved the sinonasal region and extended to the orbit.
- Histological grading confirmed the aggressive nature of the recurrent tumor.
Findings:
- Recurrent sinonasal meningiomas, particularly WHO Grade III, have a poor prognosis.
- Orbital involvement in sinonasal meningiomas is rare and associated with significant challenges.
- The case underscores the aggressive behavior and high recurrence rate of malignant meningiomas.
Implications:
- Highlights the rarity and aggressive nature of recurrent sinonasal meningiomas involving the orbit.
- Emphasizes the critical need for a multidisciplinary team approach for optimal patient management.
- Suggests the importance of vigilant follow-up for patients with high-grade meningiomas due to poor prognosis.
