Abstract
Twenty-four children with progressive chiasmatic/hypothalamic glioma (CHG) have been treated with actinomycin D and vincristine combination chemotherapy without radiotherapy and followed for a median of 4.3 yrs at the Children’s Hospital of Philadelphia, PA.
Highlights
Proptosis was a late sign of the intraorbital meningioma in this case, preceded by external deviation of the eye and loss of vision for a period of 18 mos
Meningiomas may involve the nasal wall of the orbit and invade the olfactory groove as in the present case, or may originate at the sphenoidal ridge and cause the classical syndrome of unilateral anosmia, optic atrophy or papilledema, and exophthalmos
Diagnosis and treatment of meningiomas involving the orbit and presenting with loss of vision led to improved visual acuity in 9 of 10 patients with tumors less than 3 cm diameter and in 56% of a total of 85 patients fol¬ lowed postoperatively. (Kadis GN et al Surg Neurol 1979;12:367)
Summary
Proptosis was a late sign of the intraorbital meningioma in this case, preceded by external deviation of the eye and loss of vision for a period of 18 mos. Meningiomas may involve the nasal wall of the orbit and invade the olfactory groove as in the present case, or may originate at the sphenoidal ridge and cause the classical syndrome of unilateral anosmia, optic atrophy or papilledema, and exophthalmos. Taste is partially perceived through the olfac¬ tory system, and the mother may have noticed a loss of appetite sufficient to excite an index of suspicion of involvement of the first cranial nerve, that often neglected part of the neurologic and eye examinations.
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