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Optic nerve meningioma with multiple intracranial meningiomas

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Complete loss of vision in right eye.

Patient Data

Age: 40 years
Gender: Female

Heterogeneous lesion is seen involving intraorbital, intracanalicular and
intracranial segments of right optic nerve.

Multiple extra-axial enhancing lesions are seen along falx, extending towards either side. Largest lesion measures approx 34 x 37 x 39 mm (AP x TR x CC) in high frontal region, extending towards either side of midline (RightLeft). These lesions are closely abutting/possibly infiltrating superior sagittal sinus.
Extra-axial lesions measuring approx 15 x 15 x 14 mm (AP x TR x CC) and10 x 12 x 10 mm (AP x TR x CC) are seen along left parietal convexity. Lesion measuring approx 15 x 18 x 15 mm (AP x TR x CC) is seen along left occipital convexity.

Multiple dural based areas of nodular enhancement are seen along left fronto-parietal, occipital convexities and along left tentorium cerebelli.

Few of above mentioned lesions show mild perilesional edema.

Postoperative changes are seen with evidence of left frontoparietal, occipital craniotomy and resection cavity in left frontal and left occipital lobes. Occipital resection cavity / gliotic area is pulled towards craniotomy defect.

Tram-track type of calcification is seen along right optic nerve.

Calcifications are also seen in few of the above mentioned extra-axial/dural bases lesions.

Case Discussion

Right optic nerve and multiple intracranial meningiomas as described above.

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