• Seiei Torazawa, Masahiro Shin, Hirotaka Hasegawa, Ryohei Otani, Keisuke Ueki, and Nobuhito Saito.
• Department of Neurosurgery, the University of Tokyo Hospital, Tokyo, Japan. Electronic address: tora.xxx.001@gmail.com.
• World Neurosurg. 2018 Aug 1; 116: 127-132.

BackgroundTumors extending into the optic canal can cause progressive visual impairment because of optic nerve compression. Prompt surgical resection is often necessary. When the tumor is located medially in the optic canal, endoscopic transnasal surgery provides a safer, less invasive alternative to a transcranial approach.Case DescriptionWe recently encountered a case of small solitary fibrous tumor in the optic canal causing rapid visual deterioration. The radiographic findings of preoperative imaging studies were compatible with those of meningioma; however, unlike meningioma, bleeding from the tumor was profuse during the operation. The endoscopic transnasal approach was effective for handling the highly vascularized tumor in this delicate region, and gross total removal was achieved with postoperative gradual improvement in his visual function. Nevertheless, the tumor recurred after 6 months, and re-resection was performed using the same surgical corridor, followed by adjuvant radiotherapy.ConclusionsEndoscopic transnasal surgery is a valuable option for aggressive lesions in the optic canal. Although the efficacy of radiotherapy for solitary fibrous tumor remains controversial, it should be considered when the tumor shows progressive features.Copyright © 2018 Elsevier Inc. All rights reserved.

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