A case of retro-orbital meningioma who presented to the Department of
Surgery, Neuro-surgery Unit of Tikur Anbessa Hospital in June 1993 wit
h a progressive right eye proptosis is described. Exploration through
a right frontal craniotomy showed a well circumscribed and encapsulate
d thickened bony tumor that had a cavity containing a cheesy-yellowish
oily material. The lesion was successfully shelled-out. The preoperat
ive diagnosis was meningioma. However, based on its intraoperative mac
roscopic appearance, mode of presentation, and location of the lesion
an impression of an epidermoid tumor (cholesteatoma) was made. The res
ult of histologic examination turned out to be meningioma (psammomatou
s type). Literature review on both conditions, the pathologic characte
ristics and clinical features are discussed briefly.