A NOVEL MINIMALLY INVASIVE SURGICAL APPROACH TO PRIMARY OPTIC NERVE MENINGIOMA: CASE REPORT

¹Kırıkkale Üniversitesi Tıp Fakültesi, KBB Anabilim Dalı, Kirikkale, Türkiye
²S.B. Dışkapı Y.B. Eğitim ve Araştırma Hastanesi, KBB Kliniği, Ankara, Türkiye
³S.B.Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Patoloji Kliniği, Ankara, Türkiye Primary optic nerve sheath meningiomas (ONSM) are rare tumors of optic nerve which account for approximately 5-10% of orbital neoplasms. The classic triad of optic atrophy, progressive visual loss and presence of opticociliary shunt vessels is pathognomonic for the clinical presentation of ONSM however only a few percent of cases has this classic presentation. The most common presenting symptom in these patients is painless, progressive loss of visual acuity and dyschromatopsia. On clinical examination pathologic appearance of optic disc with varying degrees of optic atrophy is commonly observed. The goal of treatment for cases of ONSM is tumor control and improvement of vision. In cases with small and non-progressive tumor and high functional vision, conservative follow-up of the lesion is appropriate since surgical excision of ONSM is generally associated with high visual morbidities. Here we present a 67-year-old female patient with primary ONSM located on retrobulbar space with a diameter of 2x2cm. On visual field test partial defect and blind spot enlargement were found. The patient underwent endoscopic resection of tumor and optic nerve decompression procedure. The operation was completed without early complication and postoperative follow-up was uneventful. Histopathological examination confirmed the diagnosis of optic nerve sheath meningioma. Keywords : Meningioma, optic nerve sheath tumors, treatment