RONOS RONOS

“The cooperation of the ophthalmologists, neurologists and neurosurgeons is the only way to solve the complex cases none could approach separately.”


MD. Tatiana Roşca




Poster presented at:

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Medical Case:
Optic nerve meningioma with an abnormal expansion
by Tatiana I. Rosca MD, PhD Benone D. Carstocea MD, PhD, Teodora Gh. Vlãdescu MD, PhD, Cecilia St. Tihoan MD, Ecaterina Al. Bontas, MD



Abstract

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Case Report


Figures - Slideshow

Note: click on the links in the page: Fig.A, to see the whole image.

Patient R.A. aged 58 living in the country side

  • History:
    - 1966 proptosis LE
    - 1978 VOS without light perception
    - 2002 pains in the left orbit
    - May 2003 transitory blurring of RE (reason of hospitalization)

Fig. 1; Fig. 2; Fig. 3; Fig. 4; Fig. 5; Fig. 6


Physical examination : within normal limits

 

 

 

 


 

Treatment

Surgery: incision of the bulbar conjunctiva around limbus, sacrifycing the extraocular muscles; a tumor formation shows up : bright white, well delimited, adhering to 2/3 posterior intraorbitary left optic nerve.


Fig. 7; Fig. 8; Fig. 9; Fig. 10; Fig.11; Fig. 12

Discussion

PECULIARITIES OF THE CASE:

  • Benign tumor formation with a long evolution of
    37 years (from 22 to 58)
  • Orbit enlarging due to the invasion process begins to
    regress quickly after surgery.
  • Visual Acuity loss was due to cyst compression and
    NOT to tumor invasion.

Conclusion

The arachnoid cyst of the optic nerve is a rare entity.
Arachnoid cysts of the optic nerve are benign, slowly progressive conditions that may result in proptosis and without treatment it causes visual loss.
The clinicopathologic features of arachnoid cyst should be differentiated from optic nerve sheath meningioma and other conditions.
This case shows, besides meningothelial cells, areas of tumor proliferation having the aspect of a meningothelial meningioma .
It may have come into being due to the mechanical pressure of the cyst on the optic nerve because the cyst was there first.
For the surgeon the clinical presentation and the images suggest the diagnosis of optic nerve tumors.
For the histopathologist is an orbital meningioma with cyst or a cyst with meningothelial cells proliferated in its wall.

References

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Last update: 13.01.2017