ABSTRACT
A 58-year-old woman with a 35-year history of left proptosis underwent neuroimaging that revealed a large cystic lesion. Surgery revealed an optic nerve sheath meningioma associated with cyst formation. The cyst was part of the tumor, a phenomenon that is well described in intracranial meningiomas but not in optic nerve sheath meningiomas.
Subject(s)
Meningioma/diagnosis , Nerve Sheath Neoplasms/diagnosis , Optic Nerve Neoplasms/diagnosis , Diagnosis, Differential , Exophthalmos/diagnosis , Exophthalmos/etiology , Female , Humans , Meningioma/complications , Meningioma/surgery , Middle Aged , Nerve Sheath Neoplasms/complications , Nerve Sheath Neoplasms/surgery , Optic Nerve Neoplasms/complications , Optic Nerve Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
Cholesterol granulomas are tumor-like lesions very rarely encountered in the orbital, frontal sinus, and maxillary sinus sites but with higher frequency in the middle-ear and petrous apex. Theoretically, cholesterol granulomas develop as a reaction to localized hemorrhages, often occurring in bony sites with no blood and blood products drainage. We present 5 cases with exophthalmoses, namely, 3 cases with granuloma and 2 cases with cholesteatoma, all being characterized by the presence of cholesterol spikes at the histologic examination. Henderson (Orbital tumors. 3rd ed. New York: Raven Press; 1994) reports cholesterol spikes in medical literature as structures with different histologic names as hematic cyst, intraorbital hematoma, subperiostal hemorrhages, chocolate cyst, and xanthomatosis reactive lesions of bone. In fact, cholesterol granuloma is the term for the pocket of hematogenous debris found in the frontal bone at surgery. We try to review the spectrum of clinical-pathological and radiographic features that characterize cholesterol granuloma but with the same surgical way management.
Subject(s)
Cholesteatoma/diagnosis , Cholesterol/metabolism , Granuloma, Foreign-Body/diagnosis , Orbital Neoplasms/diagnosis , Adult , Child , Cholesteatoma/diagnostic imaging , Cholesteatoma/pathology , Granuloma, Foreign-Body/diagnostic imaging , Granuloma, Foreign-Body/pathology , Humans , Lacrimal Apparatus/pathology , Male , Middle Aged , Orbital Neoplasms/diagnostic imaging , Orbital Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
Vascular tumors in the orbit result from new formation of vessels, proliferation of tissue components of the vessel wall, and hyperplasia of cellular elements ordinarily concerned with the genesis of vascular tissue. These vasculogenic lesions constitute the largest group of primary orbital tumors; we present the capillary hemangioma and the cavernous hemangioma.
