DR. PRITHVI VISHWANATH

DR. VARSHA BACKIAVATHY T.

Abstract

Sphenoid wing meningiomas are slow growing tumors commonly presenting with proptosis and progressive visual deterioration. Here we report an atypical presentation wherein it simulates an idiopathic orbital inflammatory disease (IOID). A young male presented with proptosis in the right eye associated with inflammatory signs such as conjunctival congestion and lid edema associated with pain. Imaging revealed a diffuse ill -defined superolateral extraconal soft tissue lesion with sclerosis and hyperostosis of the adjacent bone. Thickening of extraocular muscles involving the tendons added to the diagnostic dilemma. An incisional biopsy confirmed the diagnosis of a meningioma. A total dose of 5000cGy of radiotherapy was administered post op. At three years follow up, the patient was stable. A high index of suspicion and low threshold for histopathological diagnosis remains the cornerstone for appropriate management in cases of atypical meningiomas.