DOI QR코드

DOI QR Code

Schwannoma of the Orbit

  • Kim, Kwang Seog (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Jung, Jin Woo (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Yoon, Kyung Chul (Department of Ophthalmology, Chonnam National University Medical School) ;
  • Kwon, Yu Jin (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Hwang, Jae Ha (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Lee, Sam Yong (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School)
  • Received : 2015.06.02
  • Accepted : 2015.08.04
  • Published : 2015.08.09

Abstract

Background: A schwannoma is a benign, slow-growing peripheral nerve sheath tumor that originates from Schwann cells. Orbital schwannomas are rare, accounting for only 1% of all orbital neoplasms. In this study, we retrospectively review orbital schwannomas and characterize clinical, radiologic, and histologic features of this rare entity. Methods: A retrospective review was performed to identify patients with histologically confirmed orbital schwannoma, among a list of 437 patients who had visited our hospital with soft tissue masses within the orbit as the primary presentation between 2010 and 2014. Patient charts and medical records were reviewed for demographic information, relevant medical and family history, physical examination findings relating to ocular and extraocular sensorimotor function, operative details, postoperative complications, pathologic report, and recurrence. Results: Five patients (5/437, 1.1%) were identified as having histologically confirmed orbital schwannoma and underwent complete excision. Both computed tomography (CT) and magnetic resonance imaging (MRI) studies were not consistent in predicting histologic diagnosis. There were no complications, and none of the patients experienced significant scar formation. In two cases, patients exhibited a mild postoperative numbness of the forehead, but the patients demonstrated full recovery of sensation within 3 months after the operation. None of the five patients have experienced recurrence. Conclusion: Orbital schwannomas are relatively rare tumors. Preoperative diagnosis is difficult because of its variable presentation and location. Appropriate early assessment of orbital tumors by CT or MRI and prompt management is warranted to prevent the development of severe complications. Therefore, orbital schwannomas should be considered in the differential diagnosis of slow-growing orbital masses.

Keywords

References

  1. Rootman J, Goldberg C, Robertson W. Primary orbital schwannomas. Br J Ophthalmol 1982;66:194-204. https://doi.org/10.1136/bjo.66.3.194
  2. Mora-Rios LE, Rios Y Valles-Valles D, Flores-Estrada JJ, Rodriguez-Reyes AA. Infraorbital schwannoma: case report. Cir Cir 2014;82:76-80.
  3. Volpe NJ, Gausas RE. Optic nerve and orbital tumors. Neurosurg Clin N Am 1999;10:699-715.
  4. Lam DS, Ng JS, To KF, Abdulah V, Liew CT, Tso MO. Cystic schwannoma of the orbit. Eye (Lond) 1997;11(Pt 6):798-800. https://doi.org/10.1038/eye.1997.208
  5. Brucoli M, Giarda M, Arcuri F, Benech A. A benign isolated schwannoma of the orbit. J Craniofac Surg 2011;22:2372-4. https://doi.org/10.1097/SCS.0b013e318231e4f2
  6. Garg R, Dhawan A, Gupta N, D'Souza P. A rare case of benign isolated schwannoma in the inferior orbit. Indian J Ophthalmol 2008;56:514-5. https://doi.org/10.4103/0301-4738.43380
  7. Tezer MS, Ozcan M, Han O, Unal A, Ozlugedik S. Schwannoma originating from the infraorbital nerve: a case report. Auris Nasus Larynx 2006;33:343-5. https://doi.org/10.1016/j.anl.2005.11.015
  8. Takahashi Y, Abe T, Ueno S, Yuge T, Maruiwa H, Tokutomi T, et al. Clinicopathological features of intraorbital neurinoma: report of two cases. Kurume Med J 1998;45:151-4. https://doi.org/10.2739/kurumemedj.45.151
  9. Wang Y, Xiao LH. Orbital schwannomas: findings from magnetic resonance imaging in 62 cases. Eye (Lond) 2008;22:1034-9. https://doi.org/10.1038/sj.eye.6702832
  10. Tanaka A, Mihara F, Yoshiura T, Togao O, Kuwabara Y, Natori Y, et al. Differentiation of cavernous hemangioma from schwannoma of the orbit: a dynamic MRI study. AJR Am J Roentgenol 2004;183:1799-804. https://doi.org/10.2214/ajr.183.6.01831799
  11. Konrad EA, Thiel HJ. Schwannoma of the orbit. Ophthalmologica 1984;188:118-27. https://doi.org/10.1159/000309352
  12. Hayashi Y, Watanabe T, Kita D, Hayashi Y, Takahira M, Hamada J. Orbital cystic schwannoma originating from the frontal nerve. Case Rep Ophthalmol Med 2012;2012:604574.
  13. Malone JP, Lee WJ, Levin RJ. Clinical characteristics and treatment outcome for nonvestibular schwannomas of the head and neck. Am J Otolaryngol 2005;26:108-12. https://doi.org/10.1016/j.amjoto.2004.08.011
  14. Tsuzuki N, Katoh H, Ohnuki A, Ishihara S, Miyazawa T, Nawashiro H, et al. Cystic schwannoma of the orbit: case report. Surg Neurol 2000;54:385-7. https://doi.org/10.1016/S0090-3019(00)00278-0

Cited by

  1. INTRAORBITAL ABDUCENS NERVE SCHWANNOMA- A CASE REPORT vol.4, pp.74, 2015, https://doi.org/10.18410/jebmh/2017/876
  2. A rare case of isolated schwannoma in infraorbital nerve vol.19, pp.3, 2018, https://doi.org/10.7181/acfs.2018.02033
  3. Orbital Schwannoma vol.81, pp.4, 2020, https://doi.org/10.1055/s-0040-1713935
  4. Primary recurrent orbital schwannoma treated with surgical excision and Mitomycin-C vol.19, pp.None, 2015, https://doi.org/10.1016/j.ajoc.2020.100784
  5. Schwannoma on the nasal dorsum and tip with sensory changes vol.21, pp.6, 2015, https://doi.org/10.7181/acfs.2020.00416
  6. Accelerated growth of orbital schwannomas during pregnancy does not correlate with sex hormone- or growth factor receptor status vol.40, pp.2, 2015, https://doi.org/10.1080/01676830.2020.1747498
  7. Endoscopic endonasal resection of orbital schwannoma assisted with small-incision medial orbitotomy: case series and surgical technique vol.40, pp.6, 2015, https://doi.org/10.1080/01676830.2020.1832123