Waiting to deliver a final diagnosis

We report a patient with left eye positional transient visual obscurations, diplopia, a left afferent pupillary defect, and optic disk edema—all occurring during pregnancy. Noncontrast magnetic resonance imaging revealed an orbital mass encasing the optic nerve and extending through the superior orbital fissure into the cavernous sinus. An magnetic resonance imaging with gadolinium after parturition and strongly positive somatostatin receptor scintigraphy suggested the diagnosis of meningioma. Biopsy confirmed the diagnosis, and she was treated with CyberKnife stereotactic radiosurgery. In cases of atypical presentation, somatostatin receptor scintigraphy can help distinguish optic nerve sheath meningioma from alternative orbital masses.