Published date: Oct 25 2021

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: October–December 2021, Volume 16, Issue 4

Pages: 682–687

DOI: 10.18502/jovr.v16i4.9759

Mohammad Taher RajabiEye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

Kasra CheraqpourEye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

S. Saeed MohammadiEye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

Mohammad VeshaghOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Seyedeh Zahra Poursayed Lazarjanis.poursayed@gmail.comEye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

Farideh HosseinzadehENT and Head & Neck Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran

Fahimeh Asadi AmoliPathology Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

Simindokht HosseiniEye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran

Purpose: To report a rare case of isolated intraconal meningioma.

Case Report: A 24-year-old woman presented with painless proptosis in her left eye which started and progressed during her pregnancy about 10 months ago. Hertel exophthalomometry revealed anterior displacement of the globe with 4 mm of proptosis which was remarkable. Magnetic resonance imaging (MRI) demonstrated an intraconal circumscribed oval-shaped mass with hypointense signals on T1- weighted images and hyperintense signals on T2-weighted images, mimicking cavernous hemangioma. This mass, however, was free of any connections to optic nerve or bones. Due to the imaging characteristics, more prevalent diagnoses like cavernous hemangioma were placed on the top of the differential diagnoses list. However, during the surgical excision, the tumor’s consistency and gross features were not compatible with cavernous hemangioma. The pathologic findings instead determined meningotheliomatous meningioma, a very rare condition, which was far from our expectations prior to the surgery.

Conclusion: Ectopic orbital meningiomas are rare tumors that are not easily diagnosed without postoperative histopathology. Despite its low prevalence, they should be considered in the differential diagnosis list of intraconal masses with hypointense signals on T1-weighted images and hyperintense signals on T2- weighted images.

Keywords: Ectopic Meningioma, Intraconal Meningioma, Orbital Meningioma, Primary Meningioma

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