A Report of Intracranial Meningioma Recurring as Ectopic Orbital Meningioma Associated With Basal Encephalocele.

The authors describe a rare case of recurrent ectopic meningioma associated with sphenoid encephalocele in the medial anterior orbit of a 52-year-old man with a history of a resected intracranial meningioma. Typical features of ectopic meningioma are reviewed as well as potential etiologies of this very rare recurrence of intracranial meningioma in the orbit. Treatment is typically surgical excision.The authors report a rare case of recurrent orbital ectopic meningioma in the right medial canthus of a 52-year-old man.

Presentation and Progression of Papilledema in Cerebral Venous Sinus Thrombosis.

PURPOSE: To determine the natural history and visual outcomes of papilledema in cerebral venous sinus thrombosis (CVST). DESIGN: Retrospective observational case series. METHODS: This multicenter study included 7 tertiary care neuro-ophthalmology clinics. Sixty-five patients with CVST were identified who received serial eye examinations with documented papilledema from 2008-2016. Outcome measures included time from diagnosis to papilledema documentation, papilledema progression, time to papilledema resolution, treatment interventions and final visual outcomes. RESULTS: Papilledema was present on initial presentation in 54% of patients or detected later during the course of the disease in 46% of patients. The average time from CVST diagnosis to papilledema documentation was 29 days with a mean (SD) initial Frisén grade of 2.7 (1.3). In 21.5% of cases, papilledema progressed over an average of 55.6 (56.6) days. Time to papilledema resolution was approximately 6 months. Final visual acuity ranged from 20/20 to light perception, with 40% of patients having residual visual field defects on standard automated perimetry. Frisén grade ≥3 (odds ratio [OR] 10.21, P < .0053) and cases with worsening papilledema (3.5, P < .043) were associated with permanent visual field deficits. CONCLUSIONS: Our study indicates the importance of serial ophthalmic evaluation in all cases of CVST. Follow-up fundoscopy is critical given that a subset of cases can show delayed onset and/or worsening of papilledema with time. Specifically, we recommend an ophthalmic examination at the time of initial diagnosis, with repeat examination within a few weeks and further follow-up depending on the level of papilledema or vision changes.

Cutaneous Horn of the Eyelid in 13 Cases.

INTRODUCTION: Cutaneous horn of the eyelid is uncommon. The authors evaluate the features of benign, premalignant, and malignant tumors at the base of cutaneous horn of the eyelid. OBJECTIVE: To describe the clinical and histopathologic features of cutaneous horn of the eyelid. DESIGN: A retrospective analysis of 13 cases of cutaneous horn of the eyelid treated between 1994 and 2014 was performed. PARTICIPANTS: Thirteen patients participated in this study. MAIN OUTCOME MEASURES: Main outcome measures include clinical and histopathologic features and outcomes of cutaneous horn. RESULTS: The mean patient age was 54 years (median 64 years, range 9-91 years), and 6 patients (46%) were women. The cutaneous horn affected the upper (n = 5), lower (n = 6) eyelid, or was not indicated (n = 2). The mean height of the cutaneous horn was 7.6 mm (median 8mm, range 4-12 mm) and mean basal diameter was 3.8 mm (median 3mm, range 2-6 mm). The cutaneous horn was comprised of superficial layers of keratin with hyperkeratosis and parakeratosis overlying a solid tumor at the base in all cases. The tumor base included benign (n = 6, 46%), premalignant (n = 4, 31%), and malignant (n = 3, 23%) conditions. The benign basal lesions included seborrheic keratosis (n = 1), nevus sebaceous of Jadassohn (n = 1), pseudoepitheliomatous hyperplasia (n = 1), trichilemmoma (n = 1), and inverted follicular keratosis (n = 2). Premalignant basal lesions were actinic keratosis (n = 4), and malignant basal lesions included squamous cell carcinoma (n = 2) and sebaceous gland carcinoma (n = 1). CONCLUSIONS: The clinical significance of cutaneous horn of the eyelid lies not in the horn itself but the nature of the underlying base. Malignancy was found in 23% of patients.