Key Clinical Findings & Highlights
- Details lateral micro-orbitotomy technique for retrobulbar tumors.
- Achieves 100% vision preservation with complete proptosis reversal.
- Highlights histological confirmation of ectopic arachnoid cell origin.
Abstract
Introduction & Background
Meningiomas in the orbit typically originate from arachnoid cap cells of the optic nerve sheath (OONM) or represent secondary extensions from sphenoid ridge cranial meningiomas. True ectopic intraconal orbital meningiomas arise from displaced embryological arachnoid rests within the orbital soft tissue.
Clinical Case Presentation & Diagnosis
A 38-year-old female presented with progressive painless proptosis and diminishing visual acuity (6/18) in the right eye over 14 months. Orbital MRI demonstrated a well-delineated, homogenously enhancing 2.2 cm intraconal retrobulbar mass displacing the optic nerve medially and inferiorly without direct nerve infiltration.
Surgical Technique & Management
A lateral orbitotomy approach with microsurgical bone osteotomy was utilized. Under high operative magnification, the orbital periorbita was opened and the intraconal space was accessed between the lateral rectus and superior rectus muscles. The tumor was separated cleanly from orbital fat and the adjacent ophthalmic artery branches and excised completely.
Discussion & Literature Context
Preservation of central retinal blood supply and the delicate ciliary ganglion is critical during intraconal dissection. Histopathology confirmed meningothelial meningioma (WHO Grade I). The patient experienced complete resolution of proptosis with visual acuity improving to 6/6 at 6-month follow-up.
Conclusion
Ectopic intraconal meningiomas can be cured with complete vision retention through meticulous micro-orbitotomy dissection.
How to Cite This Research
A. K. Sharma, C. S. Gandhoke, S. Misra, A. Ravi, R. K. Gupta, Dr. Surendra K. Gupta (2021). "Ectopic intraconal orbital meningioma–A rare case report". Surgical Neurology International, Volume 12, Article 305.
