Sphenoid wing meningioma occurring as a lateral orbital mass.

Abstract

The differential diagnosis of a mass presenting in the lateral aspect of the orbit with bony erosion and involving the skin includes many malignancies, predominantly sarcomas. A total evaluation of the mass to include histopathologic characteristics and the true extent of the disease is critical to proper management of the patient. A 68-year-old man was referred for therapy with a diagnosis of fibrosarcoma. Evaluation of the disease revealed contiguous tumor from the right temporal region into the posterior orbit, with displacement of the globe and extension intracranially. During operation a frozen section analysis of the tumor was also interpreted as fibrosarcoma. A craniofacial resection was performed, including orbital exenteration and resection of a large 10 X 12 cm segment of attached dura. There was no evidence of extension into the brain. Final pathologic evaluation of the tumor was meningioma rather than fibrosarcoma. This unusual presentation of a meningioma has never been reported in the medical literature. The difficulty with interpretation of the original biopsies will be discussed, as well as the management of this case

Are bone erosion and peripheral feeding vessels hallmarks of intracranial solitary fibrous tumor/hemangiopericytoma?

“…The presence of bone erosion, absence of hyperostosis, sunburst flow void, and intratumoral calcification, and differing values of apparent diffusion coefficient have been proposed as radiological findings differentiating between meningiomas and SFT/HPCs [4] , [5] , [6] , [7] , [8] , [9] , [10] . In contrast, meningiomas accompanying bone erosion and SFT/HPCs with calcifications have also been reported [ 11 , 12 ].…”