https://imcjms.com Ibrahim Medical College Journal of Medical Science https://imcjms.com/registration/journal_full_text/227 Mon, 05 Jun 2017 09:14:05 +0000 A 42-year-old female patient presented with loss of vision and proptosis of her right eye. Computerized tomography (CT) scan revealed hyperostotic lesion involving the right sphenoid ridge, anterior clinoid process and roof and lateral wall of orbit with mass effect on the intraorbital contents. CT findings were suggestive of intra-osseous meningioma arising from right sphenoid bone. Later, MRI of the brain and orbit and histopathology of the lesion confirmed the case as an intra-osseous meningioma of the sphenoid bone. Though meningioma of tuberculum sella and primary calvarial meningioma were reported earlier, intraosseous meningioma of the sphenoid bone is rare. Address for Correspondence:Dr. Mahfuz Ara Ferdousi, Associate Professor, Radiology and Imaging, BSMMU, and Department of Radiology and Imaging, BIRDEM   Meningioma of tuberculum sella and primary calvarial meningioma were reported in Bangladesh. But, no case of intra-osseus meningioma of sphenoid bone was reported earlier in our country. Here, a rare case of intra-osseus meningioma of sphenoid wing in a female is described which was initially suspected by CT scan of the brain and orbit. Case Report The patient underwent resection of the mass, optic nerve decompression and tumor debulking with subsequent orbital reconstruction. Histopathological examination of the resected grayish white mass showed the presence of plump oval to elongated cells arranged in whorls and syncytial pattern. Some of these cells had intranuclear inclusions. The cells were infiltrating in between the bony trabeculae. Not much atypia or mitoses were seen. Histopathological diagnosis was an intraosseus meningioma (WHO grade1).     Fig-2. MR image in T1 (contrast) weighted sequence showing irregular frank expansion and deformity of right sphenoidal wing suggesting possibilities of intraosseus meningioma, bony neoplasm or polyosteotic fibrous dysplasia. Discussion Frontoparietal and orbital regions are the most common locations of intra-osseous meningiomas.7 All reported intraosseous meningiomas have been in the cranial bones.8 Extraneuraxial meningiomas can involve orbit, paranasal sinuses and nasopharynx. The symptoms of intra-osseous meningioma are mostly due to the compression of the surrounding structures as seen in our case. Dural involvement may cause pain.   1.   Buetow MP, Buetow PC, Smirniotopoulos JG. Typical, atypical, and misleading features in meningioma. Radiographics, 1997; 11(6): 1087-106. 3.   Longstreth WT, Jr., Dennis LK, McGuire VM, Drangsholt MT, Koepsell TD. Epidemiology of intracranial meningioma. Cancer 1993; 72: 639-648. 5.   Tokgoz N, Oner YA, Kaymaz M, Ucar M, Yilmaz G, Tali TE. Primary intraosseous meningioma: CT and MRI appearance. Am J. Neuroradiology 2005; 26: 2053-2056. 7.   Agrawal V, Ludwig N, Agrawal A, Bulsara KR. Intraosseous intracranial meningioma. Am J. Neuroradiology 2007; 28: 314-315. 9.   Harris WH, Dudley HR, Barry RJ. The natural history of fibrous dysplasia. An orthopaedic, pathological, and roentgenographic study. J Bone Joint Surg Am 1962; 44: 207-233. 11.Rahman L, Karmakar P. Giant meningioma of parieto-occipital lobe of brain–A case report. The Journal of Teachers Association 2003; 16(1): 30-31. 12.  Talha KA, Khan SH, Islam MT et al. A case of primary calvarial meningioma- A relative rare histologic subtype, Nepal J of Neuroscience 2009; 6: 68-71. 2026 Ibrahim Medical College. All rights reserved.