PMC6034354_01
Preoperative orbit MRI. Coronal T1 weighted image (a), coronal T1 weighted image post gadolinium enhancement (b), coronal T2 weighted image (c), and sagittal T1 weighted image post gadolinium enhancement (d) showing a well-circumscribed lesion isointensity on T1-weighted images and hypointensity on T2-weighted image with good enhancement and has small cystic/necrotic change noted in the left frontal base, orbital roof, and upper-medial orbital region. The black arrows point out the dural tail sign
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F1
This mass lesion showed relative intermediate intensity on T1-weighted image and T2-weighted image, and the postcontrast study showed good enhancement with adjacent dural tail sign causing mass effect on the left eyeball as well as the left frontal brain parenchyma, which favored meningioma [Figure 1].
Histology of the specimen. Orbital roof HE stain 200X (a), Dura HE stain 100X (b), Tumor HE stain 200X (c) showing osteoclast-like giant cells in a background of round or spindle-shaped mononuclear cells. The resected orbital roof and dura had been involved by the tumor. Tumor CD68 stain 100X (d) showing positive staining. CD68 is particularly useful as a marker for giant cells, osteoclasts
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F2
By immunohistochemistry, the tumor cells showed CD68(+), GFAP(-), EMA(-), p63(-), S100(+scattered), CD1a(+scattered), and p53(-) [Figure 2].
Post-operative orbit MRI. Coronal T1 weighted image (a), coronal T1 weighted image post gadolinium enhancement (b), coronal T2 weighted image (c) showing gross total removal of the tumor
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F3
The postoperative orbital MRI showed some postoperative change without definite residual tumor [Figure 3].