Presentation
Left proptosis.
Patient Data
Thickening of the left greater wing of sphenoid bone with low signal on T1 and T2, absent normal fat marrow and roughness of its surfaces reflecting hyperostosis. There are middle cranial fossa epidural and lateral orbital wall subperiosteal soft tissue components with post-contrast enhancement. Enhancing temporal dural tail is noted.
The lesion is encroaching upon orbital apex and exerting a mass effect on retrobulbar left orbital structures resulting in proptosis and stretching of lateral rectus muscle.
There is tight compression upon the left optic nerve at the level of orbital apex due to narrowing of optic canal.
Case Discussion
MRI features of en plaque meningioma. It is a rare tumor that commonly affects the sphenoidal ridge. It infiltrates the dura and bone, with resultant hyperostosis. It results in inward bowing and thickening of lateral orbital wall with extraconal soft tissue component encroaching upon retrobulbar structures and resulting in proptosis. It has more malignant potential than usual meningioma.
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