Intraorbital meningioma in a Young African Female: A case report

Abstract

Background: Meningiomas are tumours that arise from arachnoid cap cells of the meningeal arachnoid villi. Intraorbital meningiomas account for a small percentage of all intraorbital tumours and can either arise primarily from within the orbit or secondarily invade the orbit from the intracranial cavity.
Presenting Complaint/Investigations: We present a case of a 30 year old woman who presented with a 1 year history of gradual protrusion of the left eye, deteriorating vision and restriction of eye ball motility. A CT scan showed a soft tissue mass in the left lower orbit with a smooth outline, displacing the eyeball antero-superiorly and distinct from surrounding structures.
Diagnosis/therapeutic intervention/outcome: Surgery was done with the removal of a well circumscribed mass from the lower quadrant of the orbit via a transverse incision in the inferior conjunctival fornix. Pathological examination revealed a well circumscribed encapsulated mass with grayish white cut surfaces. Histological examination revealed a meningothelial meningioma WHO grade 1. Patient did well postoperatively with marked improvement of vision and restoration of orbital anatomy.
Conclusion: The diversity of subtypes and grades of meningioma encountered within central nervous system is not usually  encountered in primary intra-orbital meningiomas, most cases of intra-orbital meningioma are benign. Surgical removal of intra-orbital meningiomas is difficult and recurrence is common if surgical excision is incomplete. The index case appears to be completely excised.

Keywords: Intra-orbital Meningioma, Meningothelial, Ectopic