Analyses on the Misdiagnoses of 25 Patients with Unilateral Optic Nerve Sheath Meningioma
Overview
Affiliations
Aim: To investigate clinical features of optic nerve sheath meningioma (ONSM) that was misdiagnosed, and to find methods to reduce the misdiagnoses.
Methods: Retrospective series study. Twenty-five misdisgnosed patients with unilateral ONSM were collected from Jan. 2008 to Jan. 2015 and the clinical records reviewed.
Results: Patients were misdiagnosed with acute papillitis most frequently (n=17), immediately followed by optic atrophy (n=8), ischemic optic neuropathy (n=5), acute retrobulbar optic neuritis (n=5), optic disc vasculitis (n=3). For each patient, the minimum frequency of misdiagnoses was once and the maximum was 4 times. As for the lasting time of being misdiagnosed, the shortest was 1.5mo and the longest was 45mo. Twenty-one cases (84%) were once treated with glucocorticoids, and its side effects was found in seventeen patients. Twenty patients (80%) complained with varying degree of vision loss. When a definite diagnosis was made, sixteen cases (64%) showed slight exophthalmos and eighteen cases (72%) had the tubular ONSM.
Conclusion: ONSM without loss obvious exophthalmos is easily misdiagnosed in clinic, and for most of these ONSMs are tubular.
Graef J, Furth C, Kluge A, Acker G, Kord M, Zimmermann Z Cancers (Basel). 2021; 13(13).
PMID: 34282752 PMC: 8267930. DOI: 10.3390/cancers13133305.
Primary and Secondary Optic Nerve Sheath Meningioma.
Solli E, Turbin R J Neurol Surg B Skull Base. 2021; 82(1):27-71.
PMID: 33777618 PMC: 7987404. DOI: 10.1055/s-0041-1723801.
Atypical acute presentation of an optic nerve sheath meningioma.
Holan C, Homer N, Epstein A, Durairaj V Am J Ophthalmol Case Rep. 2020; 20:100951.
PMID: 33073056 PMC: 7549060. DOI: 10.1016/j.ajoc.2020.100951.
Eckert F, Clasen K, Kelbsch C, Tonagel F, Bender B, Tabatabai G Radiat Oncol. 2019; 14(1):240.
PMID: 31881902 PMC: 6935075. DOI: 10.1186/s13014-019-1438-2.
Maza G, Subramaniam S, Yanez-Siller J, Otto B, Prevedello D, Carrau R J Neurol Surg B Skull Base. 2019; 80(6):568-576.
PMID: 31750042 PMC: 6864426. DOI: 10.1055/s-0039-1677689.