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A Sphenoid en Plaque Meningioma Aggravates Exophthalmos in a Patient with Thyroid Ophthalmopathy

Purpose To describe the rare case of a patient with thyroid ophthalmopathy whose unilateral aggravated exophthalmos was caused by the development of an ipsilateral sphenoid wing en plaque meningioma. Methods Case report. Results The ophthalmologic examination included visual acuity assessment, anterior segment examination, funduscopy, ocular motility examination, and exophthalmometry. Magnetic resonance imaging (MRI) of the brain and orbit revealed the existence of a sphenoid meningioma. Removal of the tumor through a pterional craniotomy was performed. The histologic examination showed that it was an en plaque meningioma. There were no postoperative complications and no recurrence of the tumor was revealed 24 months after the operation. Conclusions Detailed ophthalmologic examination and MRI of the brain and orbit are necessary in every patient with deterioration of the exophthalmos even if the suggestive cause seems obvious.