Analyses on the misdiagnoses of 25 patients with unilateral optic nerve sheath meningioma

AIM:To investigate clinical features of optic nerve sheath meningioma(ONSM) that was misdiagnosed,and to find methods to reduce the misdiagnoses.METHODS:Retrospective series study.Twenty-five misdisgnosed patients with unilateral ONSM were collected from Jan.2008 to Jan.2015 and the clinical records reviewed.RESULTS:Patients were misdiagnosed with acute papillitis most frequently(P=17),immediately followed by optic atrophy(P=8),ischemic optic neuropathy(P=5),acute retrobulbar optic neuritis(P=5),optic disc vasculitis(P =3).For each patient,the minimum frequency of misdiagnoses was once and the maximum was 4 times.As for the lasting time of being misdiagnosed,the shortest was 1.5mo and the longest was 45 mo.Twentyone cases(84%) were once treated with glucocorticoids,and its side effects was found in seventeen patients.Twenty patients(80%) complained with varying degree of vision loss.When a definite diagnosis was made,sixteen cases(64%) showed slight exophthalmos and eighteen cases(72%) had the tubular ONSM.CONCLUSION:ONSM without loss obvious exophthalmos is easily misdiagnosed in clinic,and for most of these ONSMs are tubular.