de Silva Don J, Tay Eugene, Rose Geoffrey E
Moorfields Eye Hospital, Adnexal, London, United Kingdom.
Orbit. 2009;28(6):433-5. doi: 10.3109/01676830903177443.
Schwannomas are rare benign nerve sheath tumours that account for 1% of orbital tumours and, although sometimes associated with neurofibromatosis, most occur as isolated lesions and arise from branches of the ciliary or trigeminal nerves.
Two rare cases of Schwannoma arising within the lacrimal gland fossa are presented, these tumours being managed with intact surgical excision.
A 66-year-old Caucasian female was referred with 6 months of progressive left painless proptosis and intermittent diplopia. Restriction of left upgaze was associated with 3 mm relative proptosis. On a presumptive preoperative diagnosis of pleomorphic adenoma, the patient underwent a bone-swinging lateral orbitotomy with intact excision of a moderately-firm, lobulated lesion which proved to be a Schwannoma. A 30-year-old White female was referred with a 4-year history of slowly progressive right supratemporal periocular lump. There was 2 mm of right relative proptosis and slight restriction of right extraocular movements. Although lacrimal gland remnants were present at the edge of both specimens, at surgery it was evident that the tumours completely occupied the lacrimal gland fossa and any normal orbital lobe of the lacrimal gland had undergone atrophy.
Two very rare cases of Schwannoma arising within the lacrimal gland fossa are presented, the tumours causing complete atrophy of the normal orbital lobe of the lacrimal gland.
施万细胞瘤是罕见的良性神经鞘瘤，占眼眶肿瘤的1%，尽管有时与神经纤维瘤病相关，但大多数为孤立性病变，起源于睫状神经或三叉神经分支。
报告2例发生于泪腺窝内的罕见施万细胞瘤病例，这些肿瘤均通过完整手术切除进行治疗。
一名66岁的白种女性因进行性左侧无痛性眼球突出6个月和间歇性复视而就诊。左侧上视受限伴3mm相对眼球突出。术前初步诊断为多形性腺瘤，患者接受了外侧眼眶骨瓣切开术，完整切除了一个中等硬度、分叶状的病变，病理证实为施万细胞瘤。一名30岁的白人女性因右颞上眶周缓慢进展性肿块4年就诊。右侧有2mm相对眼球突出及右眼眼外肌运动轻度受限。尽管两个标本边缘均有泪腺残余组织，但手术中可见肿瘤完全占据泪腺窝，泪腺的任何正常眶叶均已萎缩。
报告2例非常罕见的发生于泪腺窝内的施万细胞瘤病例，肿瘤导致泪腺正常眶叶完全萎缩。
