Optic nerve sheath meningiomas (ONSMs) are rare tumors of the anterior visual pathway and constitute approximately 2% of all orbital tumors and 1-2% of all meningiomas. Untreated ONSMs almost always lead to progressive visual decline, color blindness, and finally complete loss of vision. Although re Optic nerve sheath meningiomas represent approximately 2% of all orbital tumors, as reported in large orbital tumor series by Wright et al. and Shields et al. 7,9,28,32,37,38 These lesions can arise primarily from the intraorbital or intracanalicular portion of the optic nerve sheath, or they can arise from surrounding tissues, most commonly. Optic nerve sheath meningiomas represent approximate-ly 2% of all orbital tumors, as reported in large orbital tumor series by Wright et al. and Shields et al.7,9,28,32,37,38 These lesions can arise primarily from the intraorbital or intracanalicular portion of the optic nerve sheath, or they can arise from surrounding tissues, most commonly. . Untreated ONSMs almost always lead to progressive visual decline, color blindness, and finally complete loss of vision. Although resection is warranted in cases of widespread ONSM, surgery can lead to significant morbidity Optic nerve sheath meningioma: current diagnosis and treatment
Introduction. Optic nerve sheath meningiomas (ONSMs) represent the most common tumors of the optic nerve sheath and account for one-third of primary optic nerve tumors. 1 The diagnosis is usually made by a combination of clinical and neuroimaging findings and is rarely confirmed by a biopsy. The natural history of ONSMs typically shows progressive, painless visual decline, although long. Purpose of review: Optic nerve sheath meningiomas (ONSMs) are rare benign tumors of the anterior visual pathway which present with slowly progressive and painless vision loss and account for approximately 2% of all orbital tumors. This article provides an overview as well as an update on the ONSMs with regards to cause, epidemiology, clinical presentation, diagnosis, and management in adults. Optic nerve sheath meningioma accounts for 2% of orbital tumors, 1% of central nervous system meningiomas, and 40% of optic nerve tumors. Pediatric (< 20 years old) primary optic nerve sheath meningioma represents less than 5% of cases and can be more aggressive with high recurrence rates and intracranial extension even after surgical resection . New concepts in the diagnosis and management of optic nerve sheath meningioma. J Neuroophthalmol. 2006 Sep. 26(3):200-8. . Milker-Zabel S, Huber P, Schlegel W, Debus J, Zabel-du Bois A. Fractionated stereotactic radiation therapy in the management of primary optic nerve sheath meningiomas. J Neurooncol. 2009 Apr 1. Recent therapeutic advances have increased the treatment options available to clinicians but patient management remains controversial. We systematically review the progress made in the diagnosis and management of optic nerve sheath meningiomas, clarify current best practice, and suggest future avenues for research
Introduction. Although meningiomas are reasonably common intracranial tumours, optic nerve sheath meningiomas (ONSM) as a specific subsite are infrequent, representing only 1-2% of all primary sites 1, 2, 3.Visual deterioration is a usual presenting feature, although there may be associated retro-orbital headaches and proptosis 4, 5, 6, 7.They are predominantly unilateral, the presence of. Background. Optic nerve sheath meningiomas (ONSMs) account for 2 % of orbital lesions and are the second most common optic nerve tumors, after optic nerve gliomas [1-4].Clinically, optic nerve tumors closely mimic optic neuritis with painless unilateral vision impairment [2, 5].Diagnosis remains difficult because histologic confirmation carries a high risk of visual loss
Primary optic nerve sheath meningioma Current evidence suggests that radiotherapy is the best option for long-term preservation of visual function and local tumor tion, and this will allow the institution of an earlier treatment as soon as the diagnosis is made, even if the patient is asymptom-. In general, treatment is indicated when there is a risk of spread to the central nervous system (in primary optic nerve sheath meningioma), documented progressive vision loss, or for rapid growth. Treatment alternatives are tailored to the clinical situation
It accounts for 2% of orbital neoplasms and 2% of all meningiomas. It is the second most common optic nerve tumor accounting for one third of optic nerve neoplasms (most common is optic nerve glioma). Unlike gliomas, however, optic nerve meningioma tends to affect adults more than children, with a mean age of presentation of 40 Optic nerve sheath meningiomas (ONSMs) are rare and benign tumors that affect the optic nerve. Although surgical decompression may be used for large tumors that cause mass effect on the surrounding structures, the mainstay of treatment is radiotherapy. We report the case of a 54-year-old female patient who presented with progressive vision loss due to a recurrent right ONSM despite. Introduction. Optic nerve sheath meningiomas (ONSMs) are usually benign neoplasms of the meninges surrounding the optic nerve. Patients classically present in the fourth decade with a triad of vision loss, optic atrophy, and optociliary shunt vessels on fundoscopy. 1 While optic nerve tumors are rare, ONSMs account for approximately one-third of all intrinsic tumors of the optic nerve. 2. Enhancing tissue was noted extending into the optic canal and apex of orbits surrounding the optic nerve sheath with a small amount of fat stranding this region. Additionally, there was mild hyperostosis of the planum sphenoidale on the right and a dural tail was noted. A diagnosis of optic nerve sheath meningioma was made
Optic nerve sheath meningiomas (ONSM) are rare benign tumors of the optic nerve. 60-70% of cases occur in middle age females, and is more common in older adults (mean age 44.7 years).It is also seen in children, but this is rare. The tumors grow from cells that surround the optic nerve, and as the tumor grows, it compresses the optic nerve Meningioma of the orbit. Axial sequence on T1-weighted MRI with gadolinium that shows enhancing lesion of the orbit causing proptosis and en plaque invagination laterally around the temporal pole and medially above the ethmoid sinus. Meningioma of the optic nerve sheath. Coronal section of T1-weighted MRI of the orbits that shows a left orbital. Deepali Jain, MD et al. Intraorbital Meningiomas A Pathologic Review Using Current World Health Organization Criteria. Arch Pathol Lab Med. 2010 May;134(5):766-70. Dutton JJ. Optic Nerve Sheath Meningiomas. Surv Ophthalmol. 1992 Nov-Dec;37(3):167-83. Eddleman CS, Liu JK. Optic nerve sheath meningioma: current diagnosis and treatment Abstract. Fifty patients with optic nerve sheath meningiomas have been reviewed with a follow-up of up to 15 years. The median age at onset of their symptoms was 40.0 years. The majority were middle aged females with a slowly progressive lesion. More aggressive lesions were encountered in a younger, predominantly male group of patients with.
7 Eddleman CS, Liu JK. Optic nerve sheath meningioma: current diagnosis and treatment. Neurosurg Focus 2007;23:E4. 8 Becker G, Jeremic B, Pitz S, et al. Stereotactic fractionated radiotherapy in patients with optic nerve sheath meningioma. Int J Radiat Oncol Biol Phys 2002;54:1422-9 Abstract. Objective: The management of optic nerve sheath meningiomas (ONSM) remains controversial, but includes surgery, radiotherapy and plain observation. We present a follow-up study and treatment modalities based on our classification system. Patients and Methods: A retrospective analysis was performed of 90 patients with optic nerve sheath meningiomas who were treated between 1991 and. The location of my left optic nerve meningioma is pressing on my nerve. There is nothing they can do for gamma knife or radiation therapy because it will fry the left optic nerve. The size is 10x7x7 mm. It is small, but is affecting my left eye vision. I see tunnel vision in this eye and do not see the peripheral fields Optic nerve sheath meningiomas (ONSMs) account for 2 % of orbital lesions and are the second most common optic nerve tumors, after optic nerve gliomas [1-4].Clinically, optic nerve tumors closely mimic optic neuritis with painless unilateral vision impairment [2, 5].Diagnosis remains difficult because histologic confirmation carries a high risk of visual loss
Overview. Trends in the management of optic nerve sheath meningiomas have significantly changed over the last few years. Stereotactic fractionated radiotherapy has been proven to stabilize or even improve visual function and has, therefore, become the treatment of choice in progressive and advanced cases where visual function is still present Figure 18.1 Hematoxylin and eosin (H&E) staining. A meningothelial meningioma (right) with extension in subdural and subarachnoid spaces of the optic nerve (left). Epidemiology Meningiomas typically arise in adults in their fourth to sixth decades of life and are rare in children. They are more common in African Americans and in females, with a 2 Optic nerve Sheath Meningioma. download Report . Comments . Transcription . Optic nerve Sheath Meningioma.
The best treatment of optic nerve sheath meningiomas remains controversial. Recent reports have emphasised the efficacy of fractionated stereotactic or conformal radiotherapy, and some clinicians favour this approach instead of surgery or observation.1,2 On the other hand, a beneficial effect of hydroxyurea on unresectable, residual, and recurrent meningiomas has been reported in various. New Concepts in the Diagnosis and Management of Optic Nerve Sheath Meningioma. Optic nerve sheath meningiomas are by far the most common tumors of the optic nerve sheath. The diagnosis can be suspected in most cases from clinical findings and supported by the results of neuroimaging, obviating tissue biopsy in the majority of cases
Ophthalmoscopic and photographic studies. Am J Ophthalmol 1964; 58:958-964. Wilhelm H, Dörr S, Paulsen F, et al. Early symptoms and findings in optic nerve meningiomas. Klin Monbl Augenheilkd. 2009 Nov;226(11):869-74. 3 Shapey J, Sabin HI, Danesh-Meyer HV, Kaye AH (2013) Diagnosis and management of optic nerve sheath meningiomas. J Clin Neurosci 20:1045-1056 PubMed CrossRef Google Scholar Shetty R, Babu RB, Suresh M et al (2007) Neuro-ophthalmic disorders presenting as a diagnostic surprise during pre-LASIK evaluation
Optic nerve sheath meningiomas are by far the most common tumors of the optic nerve sheath. The diagnosis can be suspected in most cases from clinical findings and supported by the results of neuroimaging, obviating tissue biopsy in the majority of cases. Observation may be appropriate in patients with mild or no visual deficit or in whom. While most meningiomas are benign or grade I, the propensity of certain subtypes to recur following treatment creates a patholog-ical course that can lead to a spectrum of malignant disease. The goal of surgery is to safely resect the tumor and obtain a diagnosis and pathological grade. Subsequent radiation therap Introduction: Meningiomas are the third most common intracranial tumors in adults after glial tumors and metastases. Olfactory groove meningiomas often grow without symptoms due to their slow growth rates and location in the frontal lobe. Optic nerve sheath meningiomas are benign neoplasms of the meninges surrounding the optic nerve The triad of visual loss, optic atrophy, and optociliary shunt veins is characteristic of an optic nerve sheath meningioma; however, it can also occur with optic nerve gliomas, sphenoid wing meningiomas, advanced glaucoma, and central retinal vein occlusion. The shunt vessels are seen in only a third of optic nerve meningiomas
Miller NR. New concepts in the diagnosis and management of optic nerve sheath meningioma. J Neuroophthalmol. 2006 Sep. 26(3):200-8. [View Abstract] Milker-Zabel S, Huber P, Schlegel W, Debus J, Zabel-du Bois A. Fractionated stereotactic radiation therapy in the management of primary optic nerve sheath meningiomas. J Neurooncol. 2009 Apr 1 . Olfactory groove meningioma - Loss of sense of smell; loss of vision (in cases where a tumor grows large enough to compress the optic nerve) Optic nerve sheath meningioma - Gradual loss of vision; color blindness; a bulging appearance in an affected eye Meningiomas represent approximately 35% of all tumors involving the optic nerve. 6,52 Among all intraorbital meningiomas, approximately 90% originate intracranially and extend through the optic canal into the orbit. 10 The remaining 10% arise from the arachnoid of the intraorbital optic nerve and are classified as optic nerve sheath meningiomas.
Introduction. Optic nerve sheath meningioma (ONSM) is a rare disease, accounting for 1% to 2% of all meningiomas; approximately 92% of ONSMs are intraorbital in origin, and 95% of these are unilateral ().ONSM occurs primarily in females, with a mean age at presentation of 40 years (1,2).The optic pathway compression, proptosis, or ocular motility disorder caused by ONSM progresses slowly (2,3) However, primary optic nerve sheath meningiomas are uncommon, accounting for 2% of all orbital tumors and 1-2% of all meningiomas. 1 One early study shows that 72% of intraocular meningiomas arise from the dural sheath of the optic nerve, and the remaining 28% are primary extradural meningiomas. 2 Clinical presentations of this intraocular.
Deutsches Ärzteblatt PP. Perspektiven. Medizin studiere Introduction. Primary optic nerve sheath meningioma (PONSM) is a proliferation of meningothelial cells within the nerve sheath of the orbital or intracanalicular portion of the optic nerve. The classic diagnostic triad includes slowly progressive, painless monocular visual loss, optic atrophy, and optociliary shunt vessels Primary Site--Brain and CNS: Are meninges surrounding cranial nerves considered cranial meninges [C700] or a part of the specific nerve's sheath? Is the primary site for an optic nerve sheath meningioma coded to optic nerve [C723] or cranial meninges [C700]? Answer Code the primary site to cranial meninges [C700]
Treatments of Optic Nerve Sheath Meningioma. Because the main effect of ONSM is vision loss, the goal of treatment is to preserve vision. Hence, treatment is recommended in cases of progressive vision loss. Observation can be warranted if the tumor is small and not affecting vision, but the patient should be monitored closely with regular. Meningioma Overview Meningioma Symptoms Meningioma Treatment: but this is unsubstantiated at the current time. Symptoms site of origin but may refer to an intracranial meningioma extending into the orbit or to a meningioma arising from the optic nerve sheath and extending into the orbit (optic nerve sheath meningioma).. The management of optic nerve sheath meningiomas. Am J Ophthalmol. 1988 Oct 15;106(4):450-7. Klink DF, Miller NR, Williams J. Preservation of residual vision 2 years after stereotactic radiosurgery for a presumed optic nerve sheath meningioma. J Neuroophthalmol. 1998 Jun;18(2):117-20 Kondziolka D, Lunsford LD, Flickinger JC radiotherapy for the treatment of optic nerve sheath meningiomas: preliminary observations of 33 optic nerves in 30 patients with historical comparison to observation with or without prior surgery. Neurosurgery. 2002; 51:890-904. 12.Turbin RE, Thompson CR, Kennerdell JS, Cockerham KP, Kupersmith MJ
Optic nerve sheath meningiomas (ONSMs) are rare tumors, representing approximately 2% of all orbital tumors, 1% to 2% of intracranial meningiomas, and one third of optic nerve lesions. 1- 4 They are usually unilateral, but 5% develop bilaterally. 5 Middle-aged woman are the most often affected. 6- 8 ONSMs are classified as primary or secondary based on their growth patterns; primary ONSMs. Background: Primary optic nerve sheath meningioma (ONSM) is a rare but almost invariably blinding tumour when its natural history is observed in a wait and see strategy. Surgery has hitherto only been advocated in case of progressive disease involving intracranial structures, as it leads to iatrogenic blindness in the overwhelming majority of cases. Therefore, treatment options bearing. Read chapter 7-23 of Current Medical Diagnosis and Treatment 2020 online now, exclusively on AccessMedicine. AccessMedicine is a subscription-based resource from McGraw Hill that features trusted medical content from the best minds in medicine Papilledema (optic disk swelling due to raised intracranial pressure) is usually bilateral and most commonly produces enlargement of the blind spot without loss of acuity (eFigure 7-66) (eFigure 7-67).Chronic papilledema, as in idiopathic intracranial hypertension and cerebral venous sinus occlusion, or severe acute papilledema may be associated with visual field loss and occasionally with.
It may seem ambitious to dedicate a textbook to the topic of optic nerve meningioma. Optic nerve sheath meningiomas are rare but diverse. The treatment is challenging and demands excellence in imaging, surgery, and radiotherapy, all of which have advanced in recent years .4-1.3% of cases ().Involvement of the optic pathways producing visual loss is not uncommon (1-3).The optic pathways can be affected within the orbit by meningiomas arising from the optic nerve sheath or within the skull by meningiomas arising from or involving the sellar and parasellar regions (2, 4)
. To accomplish this goal we first describe our institution's experience with the treatment of ONSM with radiation therapy and then use this data set as a framework for explaining the role of radiation therapy in the treatment of this uncommon tumor Turbin RE, Pokorny K. Diagnosis and treatment of orbital optic nerve sheath meningioma. Cancer Control: Journal Of The Moffitt Cancer Center. 2004;11(5):334-41. Moster ML. Detection and treatment of optic nerve sheath meningioma. Current Neurology And Neuroscience Reports. 2005;5(5):367-75. Eddleman CS, Liu JK Optic Nerve Sheath Meningioma. Optic nerve sheath meningiomas represent only 1% to 2% of meningiomas 2 but pose considerable clinical challenges owing to their intimate association with the optic nerve and its vasculature. Historically, treatments included resection or observation, both leaving patients with poor functional outcomes We hereby report the case of a patient with optic nerve sheath meningioma (ONSM), whose diagnosis and multidisciplinary management was guided by the use of Gallium-68 (68Ga)-labeled dodecanetetraacetic acid-tyrosine-3-octreotate (DOTATATE) positron emission tomography (PET)/computed tomography (CT) scan. We briefly review the diagnosis and management of ONSM, and review the literature on the. Diagnosis of meningioma was obtained either by biopsy or based on imaging assessment. Conclusion: Conservative management of orbital tumors in NF2 may be preferred in asymptomatic patients but may not be acceptable in patients with progressive visual decline. Radiation is a reasonable option for meningiomas of the orbit and optic nerve sheath
Current spontaneous urinary incontinence making impossible the safe administration of LUTATHERA; Significant toxicity related to previous radiation therapy including radiation necrosis, radiation optic neuropathy, or radiation retinopathy; Optic nerve sheath meningioma, extracranial meningioma Taking a close look at optic-nerve meningioma. OPTIC-NERVE-SHEATH meningiomas present most frequently in middle-aged women; 61% of affected patients are female, with a mean age at presentation of 41 years and only 4% under 20 years (age range 2.5-78 years). 1 The tumor typically produces slowly progressive, painless monocular visual loss which. the optic nerve sheath with a small amount of fat stranding this region. Additionally, there was mild hyperostosis of the planum sphenoidale on the right and a dural tail was noted. A diagnosis of optic nerve sheath meningioma was made. She received fractionated stereotactic radiotherapy and she reported subjective improvement in her vision. Bilateral optic nerve sheath meningioma with intracanalicular and intracranial component in a 25-year-old Saudi patient. Middle East African Journal of Ophthalmology, 2008. Sahar Elkhamary. Download PDF. Download Full PDF Package. This paper. A short summary of this paper
Optic nerve sheath meningiomas; Visual loss secondary to optic nerve drusen. Background. Optic nerve decompression surgery (also known as optic nerve sheath decompression surgery) involves cutting slits or a window in the optic nerve sheath to allow cerebrospinal fluid to escape, thereby reducing the pressure around the optic nerve However, some tumors such as gangliogliomas, medulloepitheliomas, haemangioblastomas and haemangiopericytomas are malignant gliomas. Meningioma is the most typical tumor of the optic nerve sheath. Primary sheath meningiomas arise from intraorbital or intracanalicular portions of the optic nerve. Secondary meningiomas are from intracranial sources Often used for meningioma treatment, radiation therapy is a type of cancer treatment that uses powerful X-rays to destroy cancerous cells. While there are some situations in which a small implant is used to deliver the radiation internally, external beam radiation therapy (EBRT) is more commonly used for meningioma Introduction: Meningiomas are the third most common intracranial tumors in adults after glial tumors and metastases. Olfactory groove meningiomas often gro..
Optic nerve glioma and optic nerve sheath meningioma. These are the principal tumours of the optic nerve. Gliomas tend to be a disease of early life: 90% present by age 20. Meningiomas have a peak incidence between 30 and 60 years of age. 95% are unilateral and there is a 4:1 female preponderance. Presentation Sellar and parasellar masses (craniopharyngioma, meningioma, or pituitary adenoma), optic nerve sheath meningiomas and metastatic lesions are included in the differential diagnosis. The other causes related to intracranial pathologies include hypophysis tumours, meningiomas, craniopharyngiomas and aneurisms [ 3 , 8 , 27 ] Different tumor entities include meningiomas, optic nerve gliomas, neurofibromas, schwannomas, malignant peripheral nerve sheath tumors, and granular cell tumors. This review summarizes current concepts regarding epidemiology, clinical presentation, diagnosis, pathology, immunohistochemistry, prognosis, and treatment for neural tumors of the.
Optic nerve sheath meningiomas (ONSM) are a rare subtype of meningioma. Only four retrospective studies with 3-21 patients have been published on the treatment of ONSM by radiosurgery. This study represents the largest published series on robotic radiosurgery to date, treating 25 patients with 27 ONSM lesions Optic Nerve Sheath Meningioma. Optic nerve sheath meningiomas derive from the arachnoid sheath of the optic nerve. They are the second most common optic nerve tumor, accounting for 2% of space-occupying orbital masses . Primary optic nerve meningiomas are less frequent than secondary lesions that extend into the orbit from an intracranial site Optic nerve glioma is a slow-growing tumor, which typically affects children. 30% of patients have associated NF1 & those have better prognosis. Malignant gliomas (glioblastoma) are rare & almost always occur in adult males with a very poor prognosis & almost certain death within one year. Optic-nerve gliomas Comprise about 1% of all. Papilledema occurs when raised intracranial pressure is transmitted to the optic nerve sheath. The raised pressure mechanically disrupts axoplasmic flow within the nerve. Obstipation of intra-axonal fluid results in swelling of the axons and leakage of water, protein, and other cellular contents into the extracellular space of the optic disc.
Meningiomas are the most frequent primary brain tumors ( table 1 and figure 1 ). Although most meningiomas are benign, their location in the central nervous system (CNS) can cause serious morbidity or mortality. (See Incidence of primary brain tumors .) The epidemiology, pathology, clinical presentation, and diagnosis of meningiomas will be. Background: Previous management of optic nerve sheath meningioma included conservative observation, surgery, radiosurgery and conventional radiotherapy. All carried significant risk, either of visual loss or damage to adjacent structures. Fractionated stereotactic radiotherapy appears to have few side‐effects and may preserve or improve vision. To date only three groups have published their. The optic nerve may be involved secondarily by peripheral nerve tumors in the orbit or by metastatic and infiltrative neoplasms. Optic neuropathy may also develop as a result of treatment of these tumors. Recent contributions to the literature concerning the diagnosis and management of neural orbital tumors are reviewed Optic nerve gliomas and optic nerve sheath meningiomas make up just under 4% of orbital tumors. Optic nerve gliomas and meningiomas continue to attract controversy as their natural course is still being established. Treatments for both of these conditions continue to evolve. Optic nerve gliomas are benign tumors classified as pilocytic. : Diagnosis and treatment of orbital optic nerve sheath meningioma. Cancer Control 11 : 334 - 341 , 2004 Cancer Control 11 : 334 - 341 , 2004 Eddleman CS , Liu JK
stereotactic irradiation; optic nerve sheath meningioma; The role of conventional external beam radiotherapy in the management of optic nerve sheath meningiomas (ONSM) has been controversial because of limited radiation sensitivity of these tumours and radiation damage to surrounding tissues. 1 Recently, in a study of 64 patients with ONSM managed with observation, surgery, radiotherapy, or. enhancing band-like area adjacent to the superomedial aspect of the left optic nerve sheath was identified. The diagnosis was confirmed on histopathology. Our report adds to the spectrum of presentations of this relatively common clinical entity. Keywords: Optic nerve sheath meningioma, Radiology, MRI, Histopathology 2016 The Authors There is often also enhancement of the optic nerve sheath 6,7. Treatment and prognosis. Typical optic neuritis is self-limiting, and recovery of vision usually begins within a few weeks of symptom onset 1. Response to therapy and severity also differ depending on the underlying cause