Department of Neurosurgery, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal.
World Neurosurg. 2012 Sep-Oct;78(3-4):375.e1-4. doi: 10.1016/j.wneu.2011.12.012. Epub 2011 Dec 11.
Schwannomas of the abducens nerve are extremely rare tumors. The tumor may be located within the cavernous sinus or more often at the prepontine region. However, literature research has identified only one case of isolated schwannoma of the orbit, arising from the terminal branches of the abducens nerve to the lateral rectus muscle. This is only the second report of an abducens nerve schwannoma located entirely intraconal.
We report a case of an intraorbital abducens nerve schwannoma in a 42-year-old man with no signs of neurofibromatosis. The lesion resulted in progressive diplopia and focal abducens palsy. The clinical, radiologic, and pathologic features are presented.
We point the particular aspects and discuss the possible treatments and approaches to preserve nerve function.
Being a benign lesion, one of the goals has always been total removal. The knowledge of the correct anatomic features made us believe that the VI nerve function could be preserved. Our case is the first example of a total removal with eye abduction preserved. Because of that, we believe that it is reasonable to aim for these goals in future cases.
展神经鞘瘤是一种非常罕见的肿瘤。肿瘤可能位于海绵窦内，或更常见于桥前区。然而，文献研究仅发现一例孤立性眶内展神经鞘瘤，起源于展神经至外直肌的终末分支。这是第二例完全位于眶内的展神经鞘瘤报告。
我们报告一例 42 岁男性的眶内展神经鞘瘤病例，无神经纤维瘤病迹象。病变导致进行性复视和外展神经麻痹。介绍了其临床、影像学和病理学特征。
我们指出了该病变的特殊方面，并讨论了可能的治疗方法和保留神经功能的方法。
作为良性病变，一直以来的目标之一是完全切除。对正确解剖特征的了解使我们相信可以保留 VI 神经功能。我们的病例是首例完全切除并保留眼球外展的病例。因此，我们认为在未来的病例中，这些目标是合理的。
