Sphenoid wing meningioma--an unusual cause of duro-optic calcification.
T Patankar, S Prasad, A Goel
Department of Radiology, King Edward Memorial Hospital, Mumbai, India. , India
Department of Radiology, King Edward Memorial Hospital, Mumbai, India.
Sphenoid ridge is the third commonest site of intracranial meningiomas. Although sphenoid ridge meningiomas often involve the optic canal, calcification along the optic nerve has not been reported with these tumors. We describe CT features of a calcified optic nerve in a patient with a calcified sphenoid ridge meningioma.
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Patankar T, Prasad S, Goel A. Sphenoid wing meningioma--an unusual cause of duro-optic calcification. J Postgrad Med 1997;43:48-9
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Patankar T, Prasad S, Goel A. Sphenoid wing meningioma--an unusual cause of duro-optic calcification. J Postgrad Med [serial online] 1997 [cited 2021 Apr 16 ];43:48-9
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A 47 year old woman presented with intermittent headaches and decreased vision in her right eye over a period of four months. She had progressively and completely lost vision in her left eye one year back. Clinical examination revealed complete blindness in her left eye and decreased visiual acuity in her right eye. Contrast enhanced CT scan demonstrated a large calcified meningioma of the sphenoid ridge which was in anatomical continuity with the left optic nerve which was calcified along its entire intraorbital extent [Figure:1] & [Figure:2].
The sphenoid ridge meningioma was completely excised and the patient made an uneventful recovery from the operation. The vision in her right eye improved and her headaches disappeared.
Meningiomas comprise 5-7% of all primary orbital tumors. Orbital meningiomas most commonly arise from optic nerve sheath although extraconal meningiomas arising from the orbital wall periosteum or randomly located arachnoid nests are infrequently seen. Perioptic meningiomas account for 1/3 of primary tumors of the optic nerve sheath. Secondary extension into the orbit from intracranial meningioma may also occur. They appear either as eccentric mass or as a well defined tubular thickening or fusiform enlargement of the optic nerve. Meningioma is the commonest primary nonglial, intracranial/extra-axial neoplasm affecting people in their middle and later decades of life. There is a strong female predilection with a female to male ratio 2:1 to 4:1. Sphenoid ridge account for 15-20% of intracranial meningiomas. Approximately 1/3 of sphenoid ridge meningiomas originate around the anterior clinoid process and often involve the optic canal. Calcification is seen in 20-25% of meningiomas.
In our patient, the calcified sphenoid ridge meningioma extended along the optic nerve thereby causing duro-optic calcification. Though calcified perioptic meningiomas are well documented in literature, duro-optic calcification secondary to a calcified sphenoid ridge meningioma has not been reported.
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