Title
PARASELLAR MENINGIOMA WITH OPTIC NERVE INVOLVEMENT IN YOUNG PATIENT: CASE REPORT.
Introduction
Meningiomas are benign tumors originating from arachnoid cells and represent the most common asymptomatic intracranial tumors. They are more common in women and can affect adults of any age, rarely affecting children.
Methods
A fundoscopic examination was used, followed by documentation by Optical Coherence Tomography and Retinography from optic disc, followed by contrast-enhanced orbital magnetic resonance imaging, leading to diagnostic suspicion.
Results
26-year-old male, white, with a history of progressive visual impairment in the left eye associated with diplopia, with about 6 months of evolution. He reports a history of leukemia at 3 years of age, a benign tumor in his left femur at 17 years of age and removal of two sebaceous cysts in his right hemiface last year. On ophthalmological examination on September 13, 2019, the patient presented visual acuity (AV) with the best correction of 1.00 in the right eye (DO) and worse than 0.05 in the left eye (LE). Fundus examination showed nasal blurring of the margins of the optic disc on the left side, with slight temporal pallor. Performed OCT by Swept Source (SS) on September 16, 2019, showing in the left eye optic disc with elevated nasal border. On September 26, 2019, Orbital Nuclear Magnetic Resonance was performed with contrast, showing an expansive lesion with irregular contours and a heterogeneous signal of apparent parasellar origin, infiltrating the suprasellar cistern and extending to the sphenoid sinus, orbit and left fossa temporal bone, measuring about 6.5 x 6.4 x 5.5 cm. Lesion infiltrates optic chiasm, left optic nerve, in addition to extrinsic musculature of the orbit (left lateral and inferior rectum). Exophthalmos of the left eye.
Discussion
Meningioma must be included in the differential diagnosis of optic neuritis, and it is mandatory to perform a contrast image exam for early detection of central neurological lesions.
Keywords
Meningioma, Optic Nerve, Optic Neuritis
Area
CLINICAL CASE
Authors
RODRIGO SCHWARTZ PEGADO, LEONARDO ELOY SOUSA, JARBAS DIAS FURTADO JUNIOR, JOSE DE MELO COSTA NETO