Meningioma masquerading as orbital inflammation
Author: Arshi Kabir Baig
Base Hospital / Institution: Milton Keynes University Hospital
ePoster presentation
Abstract ID: 24-142
Purpose
We present a rare case of a meningioma en plaque in a 34-year old female which initially presented with lacrimal gland swelling.
Methods
We retrospectively reviewed the case notes and conducted a literature review.
Results
Our patient presented with a six-month history of left upper lateral lid swelling and pain which was clinically thought to be chronic dacryoadenitis. Blood tests were unrevealing. An MRI confirmed left lacrimal gland inflammation along with an incidental finding of a frontal plate meningioma. There was no response to oral steroids.A lacrimal gland biopsy was planned for diagnostic purposes. When the patient attended for surgery she reported that the lacrimal gland swelling had receded, it was still visible so we proceeded with biopsy. Lacrimal gland biopsy showed only fatty infiltration. She then developed progressively worsening axial proptosis, alongside pain on eye movements and headache later attributed cranial nerve V1 compression. A repeat MRI scan featured multifocal pachymeningeal enhancement characteristic of meningioma en plaque. A neurosurgical opinion was sought, and surgical excision of the meningioma planned.
Conclusion
Meningioma en plaque is a rare infiltrative meningioma that may present with proptosis. Our patient’s presentation with possible lacrimal gland swelling was unusual and highlights the importance of revisiting our differential and repeating neuroimaging in atypical and progressive cases. We should be aware that meningioma en plaque can be a rare differential mimicking orbital inflammation.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Ariel | Ong | Milton Keynes University Hospital |
| Jennifer | Doyle | Milton Keynes University Hospital |
| Zuzana | Sipkova | Milton Keynes University Hospital |
