Sphenoid wing meningioma occurring as a lateral orbital mass.
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
D000368:Aged; D003937:Diagnosis, Differential; D005354:Fibrosarcoma / Q000175:diagnosis; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D008579:Meningioma / Q000175:diagnosis* / Q000601:surgery; D009918:Orbital Neoplasms / Q000175:diagnosis* / Q000601:surgery; D013100:Sphenoid Bone