Sphenoidal wing meningioma, an uncommom cause of proptosis(case report)

Bacground: Meningiomas account for approximately 13%-20% of all brain tumors and approximately 20% of all meningiomas are located by thesphenoid wing. They often cause no symptoms early in their development. This report is a case of sphenoid wing meningioma who presented withunilateral proptosis. Case report:A 40 year old female presented with gradually worsening vision and proptosis in her left eye.In physical exam cover test ,ocular motility and confrontation visual fields were normal. Both pupils were reactive and no APD as noted.Goldman tonometery was 14 OU. Dilated fundus exam was unremarkable.On Amsler grid she reported no metamorphopsia in their eye Retinal vasculature and macular structure were normal on FA and OCT.MRI revealed a small dural based mass with associated hyperostosis on the greater sphenoid wing and moderate periosteal reaction . Two weeks later a grade 1 meningioma was resected transcranial approach with neurosurgeon and orbital surgeon successfully and titanium medpore barrier was implanted between middle cranial fossa and orbit .the orbital apex was decompressed and exophthalmus resolved . mild enophthalmus (1mm) with normal ocular movement remained.Conclusion:Meningimas are uncommon, but approximately 20% of meningiomas are located by the greater sphenoid wing. Pupil abnormalities,visual field defects and Hertel measurements can facilitate early detection of sphenoid meningioma. Prompt intervention will limit permanentdisabilitis from these tumors.in any proptosis you should consider this diagnosis.

Keywords:

Sphenoidal wing meningioma , proptosis