Presentation
Headache, limited ocular motility and visual disturbance.
Patient Data
A sizable extra-axial mass lesion is noted at the right middle cranial fossa measuring 2.9 x 3.7 x 4.3 cm at its largest dimensions, seen lying upon the right sphenoid ridge. It displayed well-defined outlines and homogeneous T1/T2 isointense matrix to the brain. It shows intense postcontrast enhancement as well as enhancing dural tail. It is abutting the spheno-orbital fissure. Mild mass effect upon the right temporal lobe is noted with no perifocal edema
Case Discussion
This case demonstrates strong radiological features in keeping with a sphenoid wing meningioma involving the region of the anterior clinoid, adjacent medial sphenoid wing, superior orbital fissure, and cavernous sinus.
It exerts a compressive effect on the adjacent skull foramina as compression on the optic nerve.
Tumors in this region can slowly extend to the orbit resulting in slowly progressive proptosis and visual disturbance. They are also associated with sphenoid wing hyperostosis in many cases.
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