An unusual radiological presentation of optic nerve sheath meningioma

Samarawickrama, Chameen; Frydenberg, Ellen; Wells, Matthew; Steel, Timothy; Ghabrial, Raf

doi:10.1016/j.sjopt.2016.01.002

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…Some tumors, however, demonstrate alternative growth patterns to these. 35 The presence of peri-optic cysts associated with ONSMs is also well demonstrated on MRI. 36…”

Section: Diagnosismentioning

confidence: 85%

Optic nerve sheath meningiomas: prevalence, impact, and management strategies

Parker

Ovens

Fraser

et al. 2018

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Optic nerve sheath meningiomas are rare benign neoplasms of the meninges surrounding the optic nerve. They are a significant cause of morbidity. While the mortality rate is practically zero, these tumors can blind or disfigure patients. Given that the clinical course can be variable, and treatment has the capacity to cause morbidity itself, the management of these patients can be difficult. We review the literature to discuss the prevalence of optic nerve sheath meningiomas, the association with neurofibromatosis type 2, natural history, and management options and strategies.

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“…Some tumors, however, demonstrate alternative growth patterns to these. 35 The presence of peri-optic cysts associated with ONSMs is also well demonstrated on MRI. 36…”

Section: Diagnosismentioning

confidence: 85%

Optic nerve sheath meningiomas: prevalence, impact, and management strategies

Parker

Ovens

Fraser

et al. 2018

Self Cite

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“…Primary optic nerve tumors in adults can be ONSM, as well as gliomas, lymphomas, leukemic infiltration, or gangliogliomas [27]. The diagnosis of ONSM using MRI alone is not always possible [28]. The most common causes for misdiagnosis are clinician assessment failure, followed by errors in diagnostic testing [29].…”

Section: Discussionmentioning

confidence: 99%

68Ga-DOTATOC-PET/MRI—A Secure One-Stop Shop Imaging Tool for Robotic Radiosurgery Treatment Planning in Patients with Optic Nerve Sheath Meningioma

Graef

Furth

Kluge

et al. 2021

Cancers

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Optic nerve sheath meningiomas (ONSM) are rare but can lead to irreversible blindness. Hybrid imaging may enhance tumor delineation and diagnostic accuracy via receptor binding. However, relevant clinical data for ONSM are lacking. We evaluated the feasibility of receptor-based hybrid imaging prior to robotic radiosurgery (RRS). We retrospectively analyzed all of our institution’s patients with suspected ONSM who underwent combined positron emission tomography and magnetic resonance imaging (PET/MRI) with gallium-68-labeled (DOTA0-Phe1-Tyr3) octreotide (Ga68-DOTATOC) before RRS between 2018 and 2019. Eight patients with ten suspected ONSM (female = 7; median age, 51.2 years; IQR, 43.0–66.0) were included. Nine out of ten ONSM were deemed PET-positive with a median standard uptake value (SUV) max of 5.6 (IQR, 2.6–7.8). For all nine ONSM that presented 68Ga-DOTATOC uptake, hybrid PET/MRI was used for target volume contouring prior to RSS. At a median follow-up of 11.7 months (IQR, 9.4–16.4), tumor control was achieved in all patients. Radiosurgery resulted in the improvement of visual acuity in two of eight patients, whereas six showed stable vision. Ga68-DOTATOC-PET/MRI can be used for target volume contouring prior to RRS for ONSM as it enables safe treatment planning and improves diagnostic accuracy.

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“…In the first form, tumor may or may not surround the nerve, but normal subarachnoid space and CSF circulation are found between the tumor and the optic nerve. 36,44 In a second form, the tumor encircles the nerve, and the subarachnoid space is significantly reduced, although a minimal flow of CSF still separates tumor from the nerve. 44 In the third form, the CSF interface is no longer present, and the tumor begins to apply pressure to the optic nerve and its peripheral vasculature; 9,45 therefore, incomplete recovery or decline of visual function after excision could be the result of prolonged ischemia.…”

Section: Arachnoidal Planementioning

confidence: 99%

Prognostic factors in the surgical treatment of intracanalicular primary optic nerve sheath meningiomas

Rassi¹,

Prasad

Can³

et al. 2019

Journal of Neurosurgery

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OBJECTIVEAlthough meningiomas frequently involve the optic nerve, primary optic nerve sheath meningiomas (ONSMs) are rare, accounting for only 1% of all meningiomas. Given the high risk of vision loss with these tumors, surgical intervention is seldom considered, and radiation or observation is commonly applied. Here, the authors describe the visual outcomes for a series of patients who were treated with surgery aiming at maximal tumor resection and highlight their prognostic factors.METHODSThe authors retrospectively analyzed the data for 8 patients with intracanalicular ONSMs who had been surgically treated by the senior author (O.A.) between 1998 and 2016. Meningiomas extending into the optic canal from the intracranial cavity (i.e., clinoid, sphenoid wing, tuberculum sellae, diaphragma sellae) were excluded. Diagnosis was based on ophthalmological, radiological, and intraoperative findings, which were confirmed by the typical histological findings. Preoperative, postoperative, and follow-up visual assessments were performed by neuro-ophthalmologists in all cases.RESULTSThe patients included 7 females and 1 male. The mean age at diagnosis was 45.1 years (range 25.0–70.0 years). Mean duration of follow-up was 38.9 months (range 3.0–88.0 months). All patients reported visual complaints, and all had objective evidence of optic nerve dysfunction. Their evaluation included visual field, visual acuity, funduscopy, and retinal fiber thickness. Total resection was obtained in 4 cases. Comparing preoperative and postoperative visual function revealed that 4 patients had improvement at the last follow-up, 1 patient had stable vision, and 3 patients had decreased function but none had total vision loss. All patients with good preoperative visual acuity maintained this status following surgical treatment. There was no surgical mortality or infection. Operative complications included binocular diplopia in 4 patients, which remitted spontaneously.CONCLUSIONSSurgery can play a beneficial role in the primary treatment of ONSM, especially lesions located in the posterior third of the nerve. Total removal can be achieved with vision preservation or improvement, without major surgical complications, especially at early stages of the disease. Patients with good preoperative vision and CSF flow in the optic sheath have better chances of a favorable outcome than those with poor vision.

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An unusual radiological presentation of optic nerve sheath meningioma

Cited by 4 publications

References 8 publications

Optic nerve sheath meningiomas: prevalence, impact, and management strategies

Optic nerve sheath meningiomas: prevalence, impact, and management strategies

68Ga-DOTATOC-PET/MRI—A Secure One-Stop Shop Imaging Tool for Robotic Radiosurgery Treatment Planning in Patients with Optic Nerve Sheath Meningioma

Prognostic factors in the surgical treatment of intracanalicular primary optic nerve sheath meningiomas

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