Metastatic cutaneous malignant melanoma of the vitreous and retina

A case of cutaneous malignant melanoma metastasising to the retina in a 71-year-old patient who presented with vitreous opacities is discussed. In view of the increasing incidence of cutaneous malignant melanoma in our community the possibility of ocular metastases merits consideration.     

Metastatic cutaneous malignant melanoma of the vitreous and retina

A case of cutaneous malignant melanoma metastasising to the retina in a 71-year-old patient who presented with vitreous opacities is discussed. In view of the increasing incidence of cutaneous malignant melanoma in our community the possibility of ocular metastases merits consideration.     

Orbital malignant meningioma: a unique presentation of a rare entity

An elderly female with progressive proptosis was found to have an aggressive retrobulbar solid orbital mass. The mass was distinct from the optic nerve sheath and intracranial meninges, and produced concave erosion of the sphenoid wing. Operative findings demonstrated an orbital mass adherent to the dura of the superior orbital fissure. The mass did not demonstrate meningeal violation, infiltrate the superior orbital fissure, or display intracranial spread. The dura remained intact after gross total resection. Histopathology revealed a malignant meningioma with papillary and focal rhabdoid morphology and bony invasion (WHO grade III). The patient received 2500cGy of stereotactic radiotherapy in addition to gross total resection. Postoperatively, the signs and symptoms of orbital mass effect resolved (proptosis, relative afferent papillary defect, and periorbital edema) and the vision improved. There was no orbital recurrence or intracranial extension. The follow-up time was limited to eight months secondary to the patient succumbing to metastatic lung adenocarcinoma, which was demonstrated to be a separate process from the orbital meningioma. We propose the etiology of this tumor to be most consistent with an orbital malignant primary extradural meningioma – the first case reported in the literature.     

Metastatic malignant teratoid medulloepithelioma - a case report and review of the literature

Medulloepitheliomas are rare congenital tumours arising from the epithelium lining the medullary tube. They are usually detected in the first decade of life. They may be teratoid or non-teratoid. Regional and distant metastases are rare. Extraocular extension of disease appears to be the most important prognostic feature. Surgical resection is the usual mode of treatment. The role of other adjuvant modalities is as yet unclear.     

Angiomatous meningioma of orbit mimicking as malignant neoplasm: a case report and literature review

Angiomatous meningioma is a rare and distinct meningioma variant characterised with predominance of microvascularcomponent.There are few reported cases in literature with limited information on ophthalmic manifestations and radiological findings. There is no consistent feature reported so far of this neoplasm to aid in its diagnosis. Authors report an interesting case of Angiomatous Meningioma presenting as an aggressively expanding orbital mass lesion with adjacent bony destruction mimicking a malignant neoplasm.     

Orbital chordoid meningioma: a rare subtype of meningioma

A 34-year-old woman presented with progressive proptosis of the right eye for 2 years. MRI revealed a well-demarcated mass in the right intraconal space, which was isointense on T(1)- and hyperintense on T(2)-weighted images with bright uniform enhancement. The mass was resected through a lateral orbitotomy. Histopathologic examination revealed cords and clusters of spindle and epithelioid cells embedded in a myxoid matrix, with vacuolated eosinophilic cytoplasm and round nuclei. The tumor cells were diffusely positive for epithelial membrane antigen and vimentin. These findings helped confirm the diagnosis of chordoid meningioma, a rare variant of meningioma with a greater risk of recurrence and aggressive growth. Many of the clinical manifestations and imaging findings were indistinguishable from those of cavernous hemangiomas, solitary fibrous tumors, neurofibromas, and other variants of meningiomas. Given the prognostic significance of chordoid meningioma, extra care and attention should be given during surgery, histopathologic assessment, and follow-up.     

Managing menacing meningioma

The role of irradiation therapy in the management of meningiomas involving the anterior visual system is under active clinical investigation. This report documents the value of radiotherapy in a patient with a histologically verified psammomatous tuberculum sellar meningioma and presents a 15-year postsurgical follow-up. The patient experienced a return of vision from 11/200 to 20/60 in his only seeing eye following 5,000 rads to the intracanicular and intracranial portions of right optic nerve. He is able to practice his profession 3 years following irradiation therapy. The classification of optic nerve involvement by meningioma is discussed.     

儿童眼眶脑膜瘤

目的总结分析儿童脑膜瘤的特点。方法对自1978至1998二十年间天津医科大学第二医院眼科收治的18例儿童眼眶脑膜瘤的临床资料进行分析,探索儿童眼眶脑膜瘤与成人脑膜瘤的区别。结果儿童眼眶脑膜瘤的临床诊断标准与成人相同,但其男女比例为3.5:1,多发性脑膜瘤占33%,复发率为70%,恶性脑膜瘤占5.56%。结论儿童眼眶脑膜瘤的发病率低,其特点是男性居多,好多发,复发率高,恶性脑膜瘤相对多见,预后差。     

Primary optic nerve meningioma

Pathognomonic for primary optic nerve meningioma (intraorbital, intracanalicular or intracranial) is the diagnostic triad of progressive deterioration of vision (often over a period of years), primary optic atrophy and optociliary shunts ( Hoyt -Spencer sign) in a patient (frequently women) over 20 years of age. Above all at the beginning, the suspected diagnosis is retrobulbar neuritis. The correct diagnosis is made by computer tomography (enhancement with contrast, coronal sections). The author discusses whether surgical treatment ( orbitotomy or craniotomy) is to be preferred to conservative radiation therapy.     

Primary optic nerve meningioma.

Twenty-seven patients with a meningioma arising from within the optic nerve sheath have been seen during the past 12 years. Twenty-one were women, the majority aged 39--64 years. The men were younger, all except 1 being between 20 and 41 years when first seen. There were no patients younger than 20 years. Twenty-two patients had noticed a deterioration in the vision as their initial symptom. The optic nerve head was abnormal in all patients; 14 were swollen and 13 atrophic and flat. Neurofibromatosis was not associated with this condition. Treatment was essentially surgical.