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Intracanalicular meningioma with normal tomography. Case report
Journal of Neurosurgery
|May 1, 1977
Summary
A rare optic nerve sheath meningioma presented as a compressive lesion. Despite normal initial imaging, computerized tomography revealed the tumor, highlighting its potential to be missed by standard optic canal tomograms.
Area of Science:
- Neuro-oncology
- Ophthalmology
- Neuroradiology
Background:
- Compressive optic nerve lesions present with characteristic symptoms and signs.
- Standard imaging modalities like skull films, optic canal tomography, and angiography are often used for diagnosis.
Observation:
- A middle-aged woman exhibited typical symptoms of a compressive optic nerve lesion.
- Initial investigations including plain skull films, optic canal tomography, and angiography yielded normal results.
- Computerized transaxial tomography (CT) successfully identified the tumor.
Findings:
- The identified tumor was an optic nerve sheath meningioma.
- Surgical exploration revealed the meningioma was located within the optic canal, extending intracranially and orbitally.
- The tumor was strictly intradural and did not involve adjacent bone structures.
Implications:
- This case underscores that intracanalicular meningiomas can present with normal optic canal tomograms.
- Advanced imaging like CT is crucial for diagnosing optic nerve sheath meningiomas, even with initially negative findings.
- Accurate diagnosis is vital for appropriate surgical planning and management of optic nerve sheath tumors.