History of right optic meningioma treated with surgery and RT. Orbits: There are postoperative findings related to right optic nerve sheath meningioma subtotal resection with what appears to be residual tumor that measures up to approximately 15 mm in the posteronasal aspect of the orbit, which is difficult to delineate from the adjacent extraocular muscles. There is otherwise soft tissue deficiency in the right orbit with associated enophthalmos. There is metallic artifact of the right orbit, which may represent implanted hardware. There is also diffuse enhancement of the intraorbital structures, which may represent post-treatment inflammation and/or scar tissue. This is difficult to distinguish from adjacent extraocular muscles which are edematous and enhancing. The right optic nerve is markedly atrophic and deformed. The right globe is intact bilaterally. The left orbital structures are unremarkable. Brain: There is atrophy of the right optic nerve, extending to the right optic chiasm. There are a few scattered nonspecific cerebral white matter T2 hyperintense foci. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact.
1. Postoperative findings related to right optic nerve sheath meningioma subtotal resection with what appears to be residual tumor that measures up to approximately 15 mm in the posteronasal aspect of the orbit and enophthalmos.2. Diffuse patchy enhancement within rest of the right orbital soft tissues may otherwise be treatment-related.3. Extensive right optic nerve atrophy.