Patil Surendra B, Kale Satish M, Jaiswal Sumeet, Khare Nishant
Department of Plastic Surgery, Government Medical College, Nagpur, Maharashtra, India.
Indian J Plast Surg. 2010 Jul;43(2):213-5. doi: 10.4103/0970-0358.73456.
Schwannoma is a relatively rare benign tumour of peripheral nerve origin. The occurrence of Schwannoma in eyelid is extremely rare. As per our knowledge, only 11 such cases have been reported in the literature so far. We present a case of a 40-year-old man who presented to us with a 2-year history of slowly enlarging, painless mass in his left upper lid with resultant progressive ptosis. Ocular examination was suggestive of a firm, non-tender nodule of size 2 × 1.5 × 1 cm on the left upper lid. The mass was non-adherent to the skin or the underlying tissue. The eyelid skin and conjunctiva were indurated and signs of inflammation were present. The lateral part of eyelid showed presence of an ulcer and the lid function was severely hampered. Provisional clinical diagnosis was that of an eyelid malignancy. With this in mind, the medial part of the lid was excised and reconstructed using a tarso-conjunctival flap from the lower eyelid in conjunction with a skin graft. The histopathology and immunohistochemistry established the diagnosis of Schwannoma. We recommend that Schwannoma be considered in the differential diagnosis of well-circumscribed eyelid swellings.
神经鞘瘤是一种相对罕见的起源于周围神经的良性肿瘤。眼睑神经鞘瘤极为罕见。据我们所知,迄今为止文献中仅报道过11例此类病例。我们报告一例40岁男性患者,他因左上睑出现一个缓慢增大、无痛性肿块伴进行性上睑下垂2年前来就诊。眼部检查提示左上睑有一个质地硬、无压痛的结节,大小为2×1.5×1厘米。肿块与皮肤或其下组织不粘连。眼睑皮肤和结膜变硬,有炎症迹象。眼睑外侧部分有溃疡,眼睑功能严重受损。初步临床诊断为眼睑恶性肿瘤。考虑到这一点,切除了眼睑内侧部分,并使用下睑睑板结膜瓣联合皮肤移植进行重建。组织病理学和免疫组织化学检查确诊为神经鞘瘤。我们建议在鉴别诊断边界清晰的眼睑肿胀时应考虑神经鞘瘤。