Nest of Evil

Author(s): Maryam Naser, Parizad Hooshi, Danielle Westfall, Wayne Schultheis, Nafiseh Hashemi


An 83 year-old patient was referred to the neuro-ophthalmology service with symptoms of headaches and vision loss. She had been diagnosed with stable size meningioma one year prior to presentation. She had a history of breast cancer treated by lumpectomy and radiation 20 years ago. MRI of the orbit showed encasement of the optic nerve on the right orbital apex. Craniotomy was performed and the specimen was diagnosed as a meningioma. After resection, the tumor grew rapidly. When it was resected for the second time, the diagnosis was metastatic breast adenocarcinoma.

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