Anaplastic Meningioma of the Orbit

An 83-year-old woman presented with 2 months of progressive painful vision loss of the right eye. She had a previous World Health Organization (WHO) grade 1 right sphenoid wing meningioma, status postsurgical resection 2 years prior. Examination revealed a large orbital tumor and a nonformed, inferolaterally displaced globe (A). Imaging revealed a 7.5 cm × 3.8 cm × 4.2 cm intraorbital mass with intracranial extension along the temporal lobe and cavernous sinus (B). A right cranio-orbital craniotomy, orbital exenteration, and resection of the anterior/middle fossa tumor was performed (C).