Somewhere Over the Sphenoid

Weight loss; DiplopiaA 71-year old female with numbness in the right lip and cheek progressing to the right mandible and forehead. A 12-pound weight loss accompanied by horizontal diplopia further developed over an 8-month period.Right lateral rectus palsy; Superior punctate keratopathy of right cornea; Absent right corneal reflex; Dense right sensory defectsCT; MRIInfiltrating mass to the base of the middle cranial fossa.XRT1. Thomas HG, Dolman CL, Berry K: Malignant meningioma: clinical and pathological features. J. Neurosurg. 55:929-934,1981. 2. Ludwin SK, Rubinstein LJ, Russel DS: Papillary meningioma: A malignant variant of meningioma. Cancer 36:1363-1373,1975. 3. Jaaskelainen J, Haltia M, Servo A: Atypical and anaplastic meningiomas: Radiology, surgery, radiotherapy, and outcome. Surg. Neurol. 25:233-242,1986. 4. Jaaskelainen J, Haltia M, Laasonen E, Wahlstrom T, Valtonen S: The growth rate of intracranial meningiomas and its relation to histology. Surg. Neurol. 24:165-172,1985. 5. Dietemann JL, Heldt N, Burguet JL, Medjek L, Maitrot D, Wackenheim A: CT findings in malignant meningiomas. Neuroradiology 23:207-209,1982