Melanocytoma of the left optic nerve head and right retrobulbar optic neuropathy compressed by a tuberculum sellae meningioma. 
A 40-year-old woman had a highly pigmented, slightly elevated tumor on the left optic disc.  She had no visual disturbance in the left eye.  The tumor was stationary for 5 years.  At age 45 years, she complained of decreased visual acuity in the right eye.  Magnetic resonance imaging showed a right-shifted homogeneous lesion at the tuberculum sellae.  Histopathologic study of the excised lesion revealed interlacing bundles of spindle-shaped fibroblast-like cells with whorl formation.  We believe that a relationship between melanocytoma of the optic nerve head and a tuberculum sellae meningioma may exist rather than a chance occurrence, as previously suggested by others.