AB090. A rare case report: spheno-orbital meningioma with dural involvement

Background: Spheno-orbital meningiomas are rare, slow-growing tumors originating from the sphenoid ridge, causing proptosis and visual impairment. Surgical intervention can be complex due to the tumor’s proximity to critical structures.

Case Description: A 67-year-old woman presented with a gradually enlarging protrusion of her left eye over three years. Referred to the neurosurgery clinic at Hasan Sadikin Hospital, Bandung, she underwent a craniectomy with concomitant cranioplasty to remove the tumor. The surgery included resection of tissue beneath the dura. Postoperatively, the patient’s eye returned to its normal position, and her vision improved to 4/60. Spheno-orbital meningiomas, though primarily involving the sphenoid wing, can extend to surrounding tissues, complicating surgical resection. The patient’s gradual proptosis over three years signifies the slow-growing nature of these tumors. Preoperative imaging and careful surgical planning are crucial for optimal outcomes. The craniectomy approach, combined with cranioplasty, allows for effective tumor removal and restoration of cranial aesthetics. The inclusion of subdural tissue resection addresses potential residual tumor cells, minimizing recurrence risk. Postoperative recovery in this case was favorable, with significant improvement in both ocular alignment and vision. However, the vision improved to 4/60 suggests some degree of irreversible optic nerve damage, which is a common challenge in these cases. Continuous monitoring and adjunct therapies may be necessary to manage any long-term sequelae.

Conclusions: The patient’s significant improvement in visual acuity and visual field following craniectomy and tumor removal demonstrates the potential for successful treatment of these conditions. Early detection and treatment are crucial in preventing long-term visual impairment and blindness.

Keywords: Spheno-orbital meningioma; proptosis; en plaque; case report