A 28-year-old woman presented with 4 months of episodic right-eye vision loss and proptosis. Imaging demonstrated a cystic retrobulbar lesion. Lateral orbitotomy with drainage and biopsy revealed a cystic optic nerve sheath meningioma. The cyst recurred despite radiation therapy followed by craniotomy with partial resection of the meningioma. In an effort to preserve vision, an anterior orbitotomy for cyst drainage with topical mitomycin C was performed. Since this procedure, the cyst and symptoms have remained stable for 19 months. We report a case of cystic optic nerve sheath meningioma and the successful treatment of cyst recurrence with mitomycin C.
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