The use of an endoscopic endonasal approach for a secondary intraorbital meningioma: illustrative case

Author:

Guedes Breno W. M.1,de Souza Júnior Joilson F.2,D’Avila Melo Nelson A.3,de Menezes Neto João M. B.3,Beer-Furlan André4,Oliveira Arthur M. P.12

Affiliation:

1. Departments of Neurosurgery and

2. Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil; and

3. Otolaryngology, Hospital of Surgery Charitable Foundation, Aracaju, Sergipe, Brazil

4. Department of Neurosurgery, Moffitt Cancer Center, Tampa, Florida

Abstract

BACKGROUND Meningiomas are the most frequent primary tumors in the central nervous system (CNS), but intraorbital location is uncommon and accounts for only 0.2% to 4% of all CNS meningiomas. Lesions in this compartment could be classified as primary, secondary, or ectopic. The close relationship with the optic nerve sheath is a landmark to identify the tumor as primary, whereas secondary tumors commonly come from an extension of an intracranial meningioma, and ectopic meningioma is a concept not yet completely established. OBSERVATIONS The authors present a rare case of a secondary intraorbital meningioma operated through an endoscopic endonasal approach. Secondary meningiomas at the medial orbit are very uncommon, given their more common superior and lateral location as an extension of sphenoid meningiomas. The endoscopic endonasal route provides direct access to the medial orbit. The authors present an illustrative case of a meningioma located at the medial orbit and resected through an endoscopic endonasal approach that provided excellent visualization and anatomical exposure. Additionally, the authors review the concept and possible similarities between secondary and ectopic intraorbital meningiomas. LESSONS An endoscopic endonasal approach should be considered as a feasible treatment option for intraorbital meningiomas, especially if they are in the medial orbital wall.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

Management Science and Operations Research,Mechanical Engineering,Energy Engineering and Power Technology

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