Ectopic orbital meningioma: a retrospective case series
Ectopic orbital meningiomas are rare tumours that are not easily diagnosed without postoperative histopathology. This report, published in BMC Ophthalmology, highlights some of the distinguishing features of isolated orbital lesions, especially around the location of frontoethmoidal suture.

Previous data of 18 years was collected. Patient ophthalmic manifestations, radiographic features (CT and MRI), diagnosis, pathology, therapeutic regimens, and prognosis were retrospectively reviewed.

Six patients with ectopic orbital meningioma were identified. The mean age at the first visit was 33 years. All six patients displayed manifestations of exophthalmos, upper eyelid oedema, and motility impairment with a history of illness of 3–72 months.

Optical lesions were located in the superonasal extraconal compartment (50%), bitemporal extraconal compartment (1/6) and orbital intraconal compartment (2/6). Radiographic features were ill-defined, heterogeneous, enhancing soft tissue masses with extraocular muscular adhesion (all cases) and calcification (1/6), not adjacent to the optic nerve and not extending along the dura.

Six cases were treated intraoperatively with complete surgical resection, indicating that all lesions were independent of the optic nerve and sphenoid ridge. The histopathologic classification was mostly of meningothelial cells (83%). Immunohistochemistry revealed EMA and vimentin to have positive expression in all six cases, while two cases were calponin-positive and strongly expressed in the olfactory bulb. Postoperatively, lesions caused no visual impairment, and there were no cases of recurrence.

Key takeaways:-
• In the present study, orbital isolate lesions, especially around the location of the frontoethmoidal suture, had accompanying upper eyelid oedema and eye mobility restriction not observed in other orbital tumours.

• Therefore, ectopic orbital meningioma should be considered in such cases.

• Ideally, further research into the origin and pathogenesis of ectopic orbital meningiomas should be conducted.

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