Benign Meningioma With Rare Osteolytic Behavior
A 62-year-old woman presented with an incidentally discovered osteolytic mass within the left greater wing of the sphenoid (Fig. B). The patient had intact visual acuity and full extraocular motility. The 9 × 13 × 7 mm3 mass extended into the extraconal inferolateral orbit and displaced the lateral rectus muscle, demonstrated on CT axial bone windows (Fig. A). A review of the patient’s CT imaging from 7 years prior showed interval expansion of previously unnoticed bony disruption (Fig. C). A lateral orbitotomy was performed and incisional biopsy revealed meningioma, WHO grade I (Fig. D). Further tumor resection was pursued via a craniotomy in conjunction with neurosurgery.
Fewer than 2% of all meningiomas are intraosseous, the majority of which display osteoblastic activity. Historical doctrine has suggested that meningioma-induced bony degradation infers malignant pathology. This case demonstrates rare osteolytic behavior of a histologically benign intraosseous meningioma.© 2020 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.