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Retro-orbital tumor suggestive of optic nerve sheath meningocele

ABSTRACT

Meningocele of the optic nerve sheath is an extremely rare condition with a few cases reported in literature. Image studies reveal tubularcystic enlargement of the optic nerve although with the same thickness. Symptoms are often related to the involvement of the optic nerve, leading from slow to accelerated decreasing of the visual acuity. The early surgical treatment is the decompression of the optic nerve sheath, which it could provide improvement of visual function. We are presenting a case report of a patient who showed clinical and radiological signs of this rare pathological condition. Male patient attended at service complaining of proptosis of right eye (OD) since birth, in progress during the last months associated to stabbing pain. Best corrected visual acuity (BCVA) of OD was movements at 50 cm far; OS showed no abnormalities. Nuclear Magnetic Resonance of the OD showed expansive formation with cystic aspect, defined boundaries, located in an intraconal situation on the right orbit cavity and in a closing anatomical relationship to the optic nerve, inducing compression, deformity and anterior displacement of this eye besides presenting signal similar to spine liquor in all sequences obtained. The first hypothesis was meningocele of right optic nerve sheath. Then, patient was referred for surgical decompression.

Keywords:
Meningocele/diagnosis; Exophthalmia; Optic nerve/pathology; Neoplasms; Case reports

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