Kauser Hina, Rashid Omar, Anwar Waseem, Khan Sabina
Department of Ophthalmology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.
Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.
J Ophthalmic Vis Res. 2014 Oct-Dec;9(4):514-6. doi: 10.4103/2008-322X.150833.
To report a case of orbital oculomotor nerve schwannoma extending to the cavernous sinus through the superior orbital fissure presenting with proptosis, but without any neurological sign.
A 32-year-old man presented with axial proptosis of his left eye. Visual acuity and other ocular examinations were normal. Orbital magnetic resonance imaging revealed a well-defined fusiform retrobulbar lesion in the left orbit extending into the superior orbital fissure and left cavernous sinus measuring 43 mm × 21 mm × 19 mm and causing superomedial displacement of the optic nerve and axial proptosis. The patient was scheduled for surgery, and gross total excision was done. Postoperatively, the patient developed total third nerve palsy. Pre and postoperative third nerve deficit confirmed the origin of the tumor from the oculomotor nerve. Histopathological examination revealed schwannoma.
Orbital oculomotor nerve schwannoma, although rare, can be the cause of proptosis. Diagnosis can be confirmed histopathologically. It is a benign tumor; however, it can extend intracranially without any neurological symptoms. Therefore, neuroimaging is essential to rule out intracranial extension. Early surgical removal is mandatory.
报告一例眼眶动眼神经鞘瘤经眶上裂延伸至海绵窦，表现为眼球突出但无任何神经症状的病例。
一名32岁男性出现左眼轴向性眼球突出。视力及其他眼部检查均正常。眼眶磁共振成像显示左眼眶内有一个边界清晰的梭形球后病变，延伸至眶上裂和左侧海绵窦，大小为43 mm×21 mm×19 mm，导致视神经向眶上内侧移位及轴向性眼球突出。患者被安排接受手术，并进行了肿瘤全切。术后，患者出现完全性动眼神经麻痹。术前和术后的动眼神经功能缺损证实了肿瘤起源于动眼神经。组织病理学检查显示为神经鞘瘤。
眼眶动眼神经鞘瘤虽罕见，但可导致眼球突出。组织病理学检查可确诊。它是一种良性肿瘤；然而，它可在无任何神经症状的情况下向颅内延伸。因此，神经影像学检查对于排除颅内延伸至关重要。早期手术切除是必要的。
